written exam compilation.pdf

OCTOBER EXAM QUESTIONS 1. Venlafaxine wash out period to phenelzine Answer: 1-2 days AMH 2. Lawyer asks for papers to be send on behalf of patient: Answer: Give information if the patient have supplied written consent 3. Ibuprofen 400mg tab in less than 50 tabs Answer : S3 4. How much Potassium perm needed from 10% Potassium ointment to be added to 1800g of 3% Potassium ointment to make a 5% Potassium Ointment Answer : 514 gm 5. Side effects of digesting gold derivatives Answer: Metallic taste 6. Least medication that causes peripheral neuropathy 7. Which one is not a symptoms of EPSEs Answer: Constipation – options had dystonia slurred speech and dyskinesia 8. Exclusion period for Impetigo Answer: Once antibiotic treatment is started – from APF 9. Which of the medication reduces COCP efficacy Answers: Grisovin – only answer made sense 10. Best treatment for Endometriosis Answer: Goserlin 11. Reason for endometriosis 12. Which medication least suitable for Endometriosis Options were: mini pill - Levlen – Tranx Acid - Ibuprofen. I chose ibuprofen 13. How much potassium you need to make 500mL solution that 50 mL of that solution diluted to 500mL results in 0.025% w/v 14. Which one requires PBS authority Answer: Dabigatran 15. Which medication cause statin of the iris Answer: Salfazasine 16. Which one not side effects of Prednisone – you will end up with two options to choose from - One of the options will be ocular hypertension – if you look up FML you will realise is one of the side effects of cortisone so do not choose it. The other one is the answers I can’t remember the answer 17. Which medication have the least effects on renal Answer was Prednisone 18. Which medication least suitable for Angina Answer was Ramipril 1. Prednisolone 30mg initially for 3 days then reduce by 5 mg for next 3 days.You are to pack it into DAAs Choose the least number of tablets combo that patient has to take Choose 315 tablets 33 x 5 mg + 6 x 25 mg 2. Calculating 5mg/mL predmix dose for a x kg child over 3 days 3. Calculating infusion rate in mL/min for a patient if the infusion rate was reduced by 100mL/min 4. Can't really remember because it was straightforward calculations Law/Ethics 1. Lawyer requests for information about clients medication from pharmacist Torn between 2 options Don't provide Provide ANY information on written consent from the client 2. Dabigatran written authority required 3. Who cant prescribe repeats dentist 4. What schedule is ibuprofen each containing 400mg or less of ibuprofen in a pack of not more than 50 tabs 5. Customer declines to have dispensing history for particular medication uploaded on My Health Record what do u do 6. Remember which screening program is not nationwide in australia it is Prostate cancer screening program Clinical questions 1. What most likely cause nightmares chose Statin 2. What antihypertensive to use in diabetes with microalbuminuria ACEI or ARB 3. What can be used in renal impairment Prednisolone 4. What to give if child rejects oral rehydration solution but has gastroenteritis : plain water 5. What to do if child has gastroenteritis: chose give clear fluids as even if it is vomited they would have absorbed some 6. Onchomycosis in patient What are the symptoms What to treat chose terbinafine 250 mg for 12 weeks 7. Heavy menstrual bleeding/endometriosis How long to use Goserelin for 6 months Which best initial treatment for heavy menstrual bleeding chose ibuprofen 400mg tds 8. What causing the constipation - amitriptyline and dihydrocodeine 9. What to treat constipation - coloxyl with senna 10. Pregnant patient on methadone she wants to qui smoking what do u recommend chose NRT other options are Bupropion 11. Which one is not a sign of epse postural hypotension Dystonia Slurred speech Akathisia 12. Which one doesn't cause heart failure Pioglitazones Antiarrthymics Etc.... 13. Erythromycin interactions which one is correct chose erythromycin increases digoxin toxicity 14. Interaction between ciclosporin and pravastatin what to do chose option pravastatin 10mg dose reduce 15. What option is incorrect about ciclosporin and mycophenolate Take both of them 30 mins before food 16. Patient prescribed trimethoprim for UTI what statement is appropriate Chose advised her to complete the whole course Although theres another option: Advise her to use Ural alongside trimethoprim 17. Question about lady with hyperthyroidism graves disease What are the symptoms of hyperthyroidism What does carbimazole cause - agranulocytosis 18. Antidepressant changeover from venlafaxine to phenelzine wait 2 days 19. What are not symptoms of heart failure 20. Patient started on glycopyronium/indacaterol his current meds are salbutamol nebules and ipratropium nebules what should u do Chose tell him to use salbutamol and ipratropium only when required not every day 21. Hypertensive patient on prazosin and ACEI he has chronic allergic rhinitis what to do for his rhinitis Chose ask him to use steroid nasal spray 22. Diabetic patient has a corn on his foot he is on gliclazide and metformin what do u do I chose refer to podiatrist With that in mind, it seems like a good idea to remove calluses and corns, but the drugstore is not the place to start. The active ingredient in over-the-counter corn and callus removers – whether packaged as a liquid or a medicated pad – is acid, and acid can eat away live skin as well as dead. If your skin tends to heal slowly, even one application of these products can lead to the creation of a wound that can take months or even years to heal. If you have troublesome calluses or corns on your feet, see your podiatrist for advice and treatment. 23. Whats not a side effect of prednisolone: chose urinary incontinence Electrolyte disturbance Increased IOP Increased glucose level 24. What to use in primary open angle glaucoma Chose Timolol eye drop 1 eye drop bd because option for bimatoprost was wrong- bimatoprost 1 eye drop bd (should be once daily) 25. What medication does not increase falls risk forgot the options 26. What is correct about insulin Insulin isophane can be used without regard to food 27. Which cant be used with oral typhoid vaccine: I chose doxycycline Other options Aluminum hydroxide Calcium carbonate 28. What is incorrect about gold salts it causes constipation 29. Tricyclic antidepressant overdose symptoms Which one is incorrect? Chose Hypertension Initial or mild symptoms typically develop within 2 hours and include tachycardia, drowsiness, a dry mouth, nausea and vomiting, urinary retention, confusion, agitation, and headache. More severe complications include hypotension, cardiac rhythm disturbances, hallucinations, and seizures. Calculations 1. Need 154mmol of sodium chloride from 0.9% solution, atomic weight of sodium and chlorine given (total atomic weight 58.5). Calculate total volume of solution needed 0.154mmol x 10-3 = 0.154mol n=mxMm=nxM m = 0.154 x 58.5 m = 10.01 0.9%  0.9g in 100ml 10g in x ml  x = 1000ml 2. Calculate BMI and determine if patient is overweight, obese, underweight etc. 3. Calculate oral bioavailability of an IV injection if dose given via IV injection is 240mg and oral bioavailability of the dug is 60% IV = dose x oral bioavailability 240 = dose x 0.6 Dose = 240 / 0.6 Dose = 400mg 4. Dilution question: how much water to add to dilute a 40% v/v solution to 5%v/v 5. 120ml of 5% solution, calculate final concentration if 1L was added 5ml in 100ml xml in 120ml  x = 6ml 6ml in 120ml diluted with 1L of water 6ml in 1120ml xml in 100ml  x = 0.54% Legal/PBS questions - Which medication is NOT allowed to be prescribed by a midwife: o Ciprofloxacin o Cephalexin o 2 other options - Mother finds 4 tablets in her son’s room and calls the pharmacy to ask what med it is, what is the biggest concern? o Age of child o Gender of child o Etc. - Pharmacists asks you for answers for CPD questions: o Professional autonomy (from past CWH answers) - Which medication is on authority: o Isotretinoin o Azathioprine o Idarubicin o Something else - Patient presents to pharmacy, normally on Levlen, missed active pill, suspects she is pregnant, what do you do regarding ECP? o Supply 2 750mcg doses of levonorgestrel and tell her to take immediately o Refer to doctor for emergency contraception o Give 2 doses of 750mcg levonorgestrel, take 1 asap and 2 nd dose 2 hours later o Tell her to take the missed active pill as soon as possible Normal questions - Signs and symptoms of TCA overdose - Which medication has the least significant interaction with lithium? o Enalapril o Amiloride o Frusemide o Hydrochlorothiazide - Which antiemetic is most appropriate for a patient with Parkinson’s - Most suitable laxative in opioid-induced constipation - Lots of questions on rifampicin o Staining contact lenses o Hepatic function o Etc. - Antidepressant changeover from tranylcypromine to duloxetine - Exclusion period of child with impetigo - H.pylori for patient with penicillin allergy, suggest alternative o Metronidazole 400mg BD o Doxycycline o Cephalexin o Something else - Febrile seizures o Paracetamol should be used as prophylaxis o Occurs in 3% of children - Otitis media in a child, appropriate antibiotic and dose o Amoxycillin - Following questions from above, if child had a mild penicillin allergy what is the alternative: o Cefuroxime - Which is most often associated with constipation o Amitriptyline - St John’s wort doesn’t interact with which one? o Sertraline o Miancerin o Warfarin o Omeprazole - Which medication does not cause confusion? o Some antidepressants / neuro drugs o Domperidone - Which side effect is most severe with perindopril? o Angioedema o Dizziness o Etc. - Which medication is most likely to cause paraesthesia? o Acetazolamide - A patient is to start treatment for glaucoma, which one is most appropriate? o Brimatoprost 1 drop BD o Timolol 1 drop BD o Pilocarpine 1 drop BD o Bromonidine 1 drop QID - Patient diagnosed with peptic ulcers, which medicine is responsible for peptic ulcers? o Piroxicam - Patient doesn’t like to swallow esomeprazole tablets o Disperse in water and take within 30 minutes o Change to ranitidine as it can be crushed o Change to omeprazole as it can be crushed o Something else - Which agent should be given with fluorouracil to potentiate its antitumour effects? o Protamine o Glucose o 2 other options - Which medication should not be given to a patient with acute myocardial infarction? o Bivalirudin o Heparin o Aspirin o Adenosine - Which medication is not cytotoxic? o Methotrexate o Ciclosporin o Bleomycin o Something else - Which corticosteroid is most potent? o Clobetasol o Methylprednisolone o Mometasone o Betamethasone valerate - What is the oral bioavailability of acarbose? - Mother presents to pharmacy with script for 4 year old for a preventer and reliever inhaler as well as a spacer, which counselling point is most appropriate o Clean spacer with soapy water and air dry o Use a small volume spacer o Use spacer with just reliever and not preventer o Something else - Which medication has the least effects on GABA? o Antidepressants o Sleep medications o Anxiolytics - Which medication is safe to use at therapeutic doses in pregnancy? o Warfarin o Azathioprine o Clindamycin - Which medication is contraindicated in ischaemic heart disease? o Sumatriptan - What treatment of hayfever is most suitable for a patient who is using amitriptyline o Loratadine - Which indication is azathioprine not suitable for? o Osteoarthritis o Lupus o Organ transplantation rejection o Rheumatoid arthritis - Which medication is suitable to be used in a patient who is stabilized on warfarin? o Flucloxacillin o Erythromycin o Clarithromycin o Rifampicin - Which medication is contraindicated with moclobemide? o Pethidine o Fentanyl o 2 other options Calculations:  Simple dilutions  Total Prednisolone tablets if 30mg tablets for 3 days and reduce by 5mg every 3 days  Total dose for premix with the child who is weight 32kg for the course of 4 days  Infusion rate ml/min Legal/PBS:  Who cannot issue repeat: Dentist  Cannabis prescription for nausea and vomiting, what is the requirement before dispensing  Privacy: need patient consent before supplying info  Patient does not want info appear on My health record Therapeutics:  Drugs in heart failure  Drugs for acute MI  Interactions with Ciclosporin  Signs and symptoms of Endometriosis, Grave’s disease, chicken pox, onchomycosis  Exclusion period of Impetigo  Laxatives in opioid-induced constipation  Drugs induce rebound headache, falls in elderly, nightmares  Drug that needs high fluids intake  Oral typhoid interacts with doxycycline  Drug does not affected by renal impairment  Drugs cause neutropenia 1. What is the bioavailability of acarbose - 1% to 2% - 5 % to 6% - and other options that were higher percentages 2. Which of these statins are least likely to be affected by CYP450 enzymes - atorvastatin - simvastatin - fluvastatin - pravastatin 3. Which medicine requires PBS authority approval - isotretinoin - azathioprine - idarubicin -? 4. Which cofactor is coadministrated with fluorouracil to increase its potency (anticancer activity) - protamine - glucagon - calcium folinate -? 5. Which of these is not a cytotoxic agent? - ciclosporin - methotrexate - fluorouracil - [don’t remember the drug, but it was a cytotoxic agent] 6. Which of these can be prescribed by an authorised midwife under the Pharmaceutical Benefits Scheme? - clindamycin - cephalexin - nitrofurantoin - rifampicin 7. Before [name of a cannabinoid] can be supplied, which of the following needs to be done first? - approval by Secretary of the Department of Health and Ageing - approval by a federal authority - private prescription approved by both a specialist and a GP -? 8. Which of these medicines can be safely administered with warfarin? - flucloxacillin - diclofenac - clarithromycin - erythromycin 9. A 20 year old regular female customer comes into the pharmacy. She normally takes the COCP in the morning. It is now late afternoon. What is the most appropriate advice you can give her? - Give her two levonorgestrel 75mg capsules and tell her to take one now and one an hour later - Tell her to take her “missed pill” later in the evening and continue the regimen as normal - Refer her to her doctor for emergency contraception - Give her two levonorgestrel 75mg capsules and tell her to take both as a single dose 10. Which of these is least likely to interact with moclobemide? - paracetamol + codeine - pethidine - fentanyl -? 11. Which of these is least likely to cause falls in the elderly - Antiarrhythmic - Amitriptyline - Hypertensive agent - ? [something that caused dizziness. Nitrate?] 12. Which of these is most likely to cause constipation? - rivastigmine - sertraline -? -? 13. Which of these is paraesthesia (tingling and prickling sensation of the face, hands and feet) a common adverse effect - acetazolamide -? -? -? 12. Which of these regimens is the most appropriate treatment for a person with open angle glaucoma - Bimatoprost 1 drop twice daily - Brimonidine 1 drop 4 times daily - Timolol 1 drop twice daily - Pilocarpine 1 drop twice daily 13. Which of these statements is the most appropriate? - Timolol cannot be used in conjunction with brimonidine - Latanoprost causes permanent thinning of the eyelashes - Brinzolamide is not as effective as acetazolamide but has fewer systemic effects - Carbonic anhydrase inhibitors can cause miosis 14. A mother comes in with a script for fluticasone and salbutamol for her son. Which of the following advice is most appropriate? - A volumetric spacer is needed for the fluticasone but not for the salbutamol - Wash the spacer in warm soapy water, and hang to air dry after every use - A small volumetric spacer is needed for both medicines - Spacers are not needed 15. You have 120 mL of a 5% w/v solution containing magnesium. What’s the final concentration after adding the solution to 1L of 0.9% sodium chloride? 16. Which of these are not used for treatment of myocardial infarctions? - adenosine - heparin - bivalirudin - aspirin 17. Which of these statements about febrile convulsions is most appropriate? - Febrile convulsions affect up to 3% of children - Febrile convulsions are generally brief - Preventative anticonvulsants are recommended - There is a low risk of recurrence of febrile convulsions 18. Which of these statements is least appropriate? - Antipyretics should be used regularly to prevent febrile convulsions - Antipyretics are used for the comfort of the child - Fever is not known to have lasting damage on the brain and other organs -? 19. A mother of a child who has febrile convulsions has asked for a product/advice to lower her child’s temperature. Which is most appropriate? - Paracetamol - Putting the child in a cold bath -? -? 20. Which of these is a disease modifying antirheumatic agent - leflunomide - none of the other options were DMARDs 21. A man has been admitted into the hospital newly diagnosed with cerebral metastases, so phenytoin 100mg tds was initiated. He also suffers from depression, has [prostate?] cancer, and takes opioid analgesics. Which of these statements is most appropriate for his treatment? - The dose of phenytoin may be increased - Phenytoin increases the concentration of fluoxetine and therapeutic effect of fluoxetine should be monitored - Phenytoin decreases the concentration of methadone and the therapeutic effect of methadone should be monitored - Phenytoin decreases the concentration of morphine and the therapeutic effect of morphine should be monitored 22. Which of these statements about rifampicin is most appropriate? - discolours soft contact lenses - does not affect liver enzymes - dose adjustment is needed in renal impairment -? 23. For a patient who requires H pylori eradication but has anaphylaxis to penicillins, which drug and its dosage should amoxicillin be substituted by? 24. A patient requires H pylori eradication and is newly diagnosed with a gastric ulcer. His doctor has prescribed 3 months of esomeprazole for him after he finishes his HP7 regimen. He does not like swallowing tablets and has asked if there’s any other ways to take it. What is the most appropriate course of action here? - Contact doctor to switch to ranitidine since it has better efficacy and can be crushed - Tell the patient to break the esomeprazole tablets in half so that they are easier to swallow - Contact doctor to switch to omeprazole tablets which can be crushed - Tell the patient to disperse the esomeprazole tablets in water and drink it within 30 minutes 25. The patient has been newly diagnosed with a gastric ulcer. Which of these medicines is most likely responsible for his ulcer - regular use of piroxicam - regular use of paracetamol -? -? 26. A doctor contacts you to ask to be recommended an anti-emetic for one of your regulars. She takes levothyroxine, levodopa/carbidopa, simvastatin. Which is the most appropriate? - Metoclopramide - Prochlorperazine - Domperidone - Promethazine 27. Which of these drugs is most likely to cause rebound headache? - Sumatriptan - Amitriptyline - ? [I think there was a non-pain relief option, but a common side effect of it was headache. Perhaps a nitrate?] -? 28. Which of these drugs do not work on the GABA mechanism of the CNS - antidepressants - sleep disorder medicines - anxiolytics - muscle relaxants 29. A woman is complaining of having a dry mouth. Which of these drugs she takes is most likely to cause the dry mouth? - amitriptyline - [I do not remember the other options] 30. Which of these products would you recommend for her dry mouth? - Nilstat mouthwash - Benzydamine throat lozenges - Artificial saliva - Chlorhexidine mouth wash 31. Which of these is least appropriate for opioid-induced constipation? - Macrogol - Lactulose - Docusate and senna - Psyllium 32. Which of these is the most appropriate treatment recommendation for opioid-induced constipation? - Take regular intake of psyllium - Use a stool softener without a stimulating agent - Use an osmotic laxative -? 33. Which is the most appropriate treatment regimen for a 6 year old with otitis media? - Amoxicillin suspension 15mg/kg tds - Amoxicillin suspension 30mg/kg as a daily dose - Amoxicillin and clavulanic acid suspension [with an appropriate dose] - Ciprofloxacin suspension [with an appropriate dose] 34. A boy has been diagnosed with otitis media. Which of his symptoms is not reminiscent of otitis media? - Pain in ear - Irritability - Fever - Wheezing with a productive cough 35. Which of these side effects is most clinically severe in carbimazole? - agranulocytosis - itch - [do not remember the other options] 36. Which of these side effects is most clinically important in ramipril? - angioedema - dizziness - hepatitis -? 37. Which is the most appropriate antihypertensive in a diabetic patient with microalbuminuria? - verapamil - hydrochlorothiazide - ramipril - amiodarone 38. Which would not be an appropriate additional antihypertensive agent in a person who takes amiloride/hydrochlorothiazide? - atenolol - enalapril - prazosin - ? [an antihypertensive that is neither an ACE inhibitor nor a sartan] Preterm labour medication - corticosteroid Which Antibiotic cause hepatic impairment - (trimethoprim, amoxil, flucloxacillin*, clarithromycin) Tx for Hepatic encephalopathy to remove excess ammonium ions (choose the one with lactulose) Question about which one is not including in National screening program. PBS ⁃Ask about deferring script ⁃Prescriber bag list (haloperidol) Which one of the following doesn’t related to tacrolimus adverse effects ? ⁃Myelosuppression Question about Major interaction ? Azathiopurine and allopurinol interaction Which tab when cut into half will Alter pharmacokinetic profile ? ⁃carbamazepine CR ⁃Verapamil CR ⁃OxyContin CR ⁃Finasteride CR Ethics : Pharmacist get the highest sale for selling product and get rewarded by owner - Pharmacist autonomy A lawyer ask you about the information for his client’s medication from another medical practitioner. Would u provide the information? Options listed: ⁃No information provide ⁃Provide information, after getting written consent from the client(patient) ⁃Provide information straightly ⁃*forgot the last option Question about how to take Typhoid oral vaccine Case study about Danazol ⁃why need extra contraceptive when taking danazol ? (Danazol cannot fully inhibit ovulation ) ⁃Patient sufferers side effects of Danazol : acne, voice change.. what would u do ? (Ask her to stop Danazol and see doctor immediately) Heavy bleeding tx - tranxenamic acid Impetigo - can go back to school once antibiotic treatments starts Case study about hyperthyroidism ⁃Ask about symptoms and side effects ⁃weight loss, insomnia, frequency of bowel motion ⁃Severe Side effect : agranulocytosis Case study about the patient have positive of h.pylori infection, lab test showing low haemoglobin. Which type of microcytic anaemia ? ⁃iron deficiency anaemia ⁃Vitamin b12 deficiency ⁃Folic acid deficiency ⁃Renal failure Question about symptoms of serotonin toxicity. Which type of laxatives will u choose for patient using hydromorphone? ⁃Docusate and senna Which one can cause GORD? ⁃lettuce ⁃Tomato ⁃Onion ⁃Peppermint Which drug will not have interaction with COC? ⁃allopurinol ⁃Verapamil ⁃Rifampicin ⁃Carbamazepine Question related to rifampicin ⁃discolour contact lenses Which drug is not using for acute myocardial infarction? ⁃adenosine ⁃Heparin ⁃Bivalirudin ⁃Aspirin Which medication cause phototoxicity ? ⁃Chlorpromazine Which medication will not induce asthma ? ⁃Verapamil Patient with dementia should avoid which type of medication ? ⁃anticholinergic medication Medication avoid in Pregnancy ? ⁃thalidomide Calculation 1. How many grams of 10% salicylic acid ointment needed if combine with 1800g of 3% salicylic acid ointment to produce a final product of 5% salicylic acid ointment ? (Answer:540g) 2. Calculate break-through pain dose 3. Patient previously on 1150units/hour of Heparin infusion (25000units/500ml), now they want to reduce the infuse by 100units/hour , what is the infusion rate now ? Answer: 21ml/hr 4. Question about opioid conversion from hydromorphone to morphine dose. 5. Question about patient taking 2 ural sachet 4 times a day, calculate the weight sodium that the patient consume daily. (They provided the weight and molecular weight of sodium and sodium bicarbonate ) 6. Question about dilution: (about the same as APC sample question) how many grams of X needed in 500ml, if 25ml of X is taken out and diluted up to 500ml to make a final product with 0.025% w/v Frequently referred to AMH for heart failure, psychotropics, verapamil and isotretinoin. 1. Question stem a. Option A b. Option B c. Option C d. Option D 2. A patient who is anaphylactic to amoxicillin needs to be treated for cellulitis. What’s the best treatment option? a. Flucloxacillin 500 mg q6h for 5 days. b. Cefalexin 500 mg q6h for 5 days c. Clindamycin 450 mg q8h for 5 days d. One other option for 5 days 3. Which is likely most effective for severe acne? a. Cyproterone + ethinylestradiol b. Ethinylestradiol +norethisterone c. Ethinylestradiol + levonorgestrel d. Norethisterone 4. Which is not part of the national cancer screening program? a. Breast cancer in women 50-74 years b. Bowel cancer for 50-74 years c. Cervical cancer in women > 25 years d. Prostate cancer in men > 30 years 5. How much 10% salicylic acid ointment should you add to 1800 g 3% salicylic acid ointment, to make 5% salicylic acid? a. 720 g ointment. 6. How long does it take for 5 alpha reductase inhibitors (dutasteride, finasteride) to improve symptoms of BPH? a. 6 months or more. 7. Which food is most likely to cause heartburn? [recycled question] a. Lettuce b. Onion c. Tomato d. Peppermint 8. Patient profile: brick layer, accidentally splashed some chemicals into his eye 45 mins ago. He’s washed it with water for 20-30 mins but still feels irritated and blurred vision. What next? a. Refer 9. Same patient, been using Chlorsig ointment 3-4 times a day, but now presents with copious eye discharge. What do you advise? a. Irrigate with saline b. Refer to doctor c. Switch ointment to Chlorsig drops as it’s less viscous d. Give levocabastine eye drops 10. Which drug causes parasthesia? a. Acetazolamide 11. Which statements about insulin is true? a. Glargine can be mixed with other insulins b. Aspart can be injected 20 min before meals c. Isophane can be injected regardless of mealtimes. d. ? 12. When is amoxicillin + clavulanic acid used over amoxicillin alone? a. When resistance is suspected or proven. 13. Which of the following can stain teeth? a. Ferrous sulfate b. Benzydamine hydrochloride c. Nystatin d. Choline salicylate 14. What’s the most suitable treatment for fungal nail infection? a. Miconazole b. Econazole c. Terbinafine 250 mg tablets d. ? 15. [can’t recall question stem, something about teratogenic drugs; two questions went like this:] Which of the following drugs are doctors required by law to advise women NOT to fall pregnant during treatment and for at least a month after stopping it? - isotretinoin Which of the following drugs has the longest duration for which a female patient should not become pregnant? – acitretin (2-3 years) a. Valganciclovir b. Thalidomide c. Acitretin d. Isotretinoin e. Bosentan 16. What factors are not considered in the CHA2DS2VA score? a. Heart failure b. Alcohol intake c. Hypertension d. Diabetes 17. Patient profile. Taking heaps of meds. Which of his medications most likely contributes to his visual disturbances? a. Digoxin 18. The dose equivalence of hydromorphone to morphine is 3:30. How much hydromorphone is equivalent to morphine 120 mg? a. 12 mg 19. Patient profile. Presenting complaint gastritis, and some others Medical history parkinson’s disease, osteoporosis. Medications alendronate 70 mg weekly levodopa/carbidopa 100/25mg QID (last dose 4 pm) etc. Patient has morning dyskinesia. How to treat? a. Start selegiline b. Give controlled release levodopa/carbidopa c. Increase 4pm dose of levodopa/carbidopa 20. Patient developed swallowing difficulties. Dr decides to change levodopa/carbidopa to a dispersible levodopa/benserazide. Your thoughts? a. Inappropriate, as the tablets can be used to make an extemporaneous liquid. b. Appropriate, so long as total daily dose of levodopa is the same. c. Appropriate, but monitor patient and adjust dose as necessary. d. ? 21. Patient complained her gastritis worsened. What’s the best course of action? a. Change alendronate 70 mg weekly to 10 mg daily b. Withhold calcium and vitamin D supplement c. Contact Dr to withhold alendronate, prescribe omeprazole 20 mg and review. 22. Mebendazole – which counselling point is appropriate? a. It treats all types of worms b. Treat all family members and children over 6 months. c. Repeat course 1 week later. d. ? 23. Which drugs are not capable of worsening heart failure? a. TCAs b. Sartans c. Calcium channel blockers (verapamil, diltiazem) d. Risperidone (?) 24. Which drugs do not interact with the combined oral contraceptive? [recycled question] a. Rifampicin b. Carbamazepine c. Allopurinol d. Verapamil 25. Which schedule does acyclovir belong to? [recycled question] a. Unscheduled b. Schedule 2 c. Schedule 3 d. Schedule 4 26. A lady takes 2 Ural sachets 4 times a day. Some of its ingredients are listed below: Sodium bicarbonate 1.76 g, tartaric acid 890 mg, citric acid anhydrous 720 mg, How much sodium did she consume each day? (molecular weights: NaHCO3 84.01, Na 22.99) mass of sodium per sachet = 1.76 *22.99 / 84.01 = 0.481 g Mass of sodium intake per day = 0.481 x 2 x 4 = 3.85 g 27. Patient profile. Current medicines Ramipril Simvastatin 2 other meds The patient was commenced amiodarone with loading dose in hospital. What changes would you recommend to his current medicines? a. Stop simvastatin b. Change simvastatin to pravastatin 28. Patient has worsening depression; doctor wants to switch her from doxepin to sertraline. What’s the best way to changeover? a. Withdraw doxepin for 2 weeks before starting sertraline [2 weeks without drug treatment] b. Withdraw doxepin over 4 days, then start sertraline 2-4 days later. c. Withdraw doxepin over 1 week, then start sertraline 4 days later. 29. Which statement about febrile seizures is true/false? a. Febrile seizures happen to 3% of children 6 months – 5 years of age. b. Antipyretics prevent febrile seizures [false] c. ? 30. Patients with dementia would be most sensitive to… a. Serotonergic agents b. Beta blockers c. Anticholinergics 31. Clozapine patients need regular blood tests to monitor for… a. Agranulocytosis b. Myocarditis c. Hemochromatosis d. ? 32. Amitriptyline is metabolized into… a. Nortriptyline 33. Which drug is suitable for treating post-herpetic neuralgia? a. Phenytoin b. Gabapentin c. Oxycodone CR d. Topiramate 34. Which vaccine is recommended for people 65 years and over? a. Herpes zoster b. Pneumococcal 13-valent [no, it’s 23-valent] c. 2 other options 35. Acyclovir scheduling [recycled question] a. Unscheduled b. Schedule 2 c. Schedule 3 d. Schedule 4 36. Colleague asks for CPD answers. What is the concern here? [recycled question] a. Patient safety b. Privacy c. Professional autonomy d. ? 37. What is the bioavailability of acarbose? a. 1-2 % b. Other percentages range up to 20 % 38. Which pair of drugs are most commonly prescribed together? a. Verapamil + amiodarone b. Amlodipine + isosorbide mononitrate c. Levodopa + metoclopramide d. Ivabradine + verapamil 39. What is used to treat organophosphate poisoning? a. Atropine. 40. Which drug is least likely to interact / increase the effects of alcohol? a. Griseofulvin b. Metronidazole c. Sertraline d. Fexofenadine 41. Which drug is used to treat orthostatic hypotension? a. Hydrocortisone b. Fludrocortisone c. 2 other options 42. Methotrexate is used for rheumatoid arthritis. What other indications does methotrexate have? a. Crohn’s disease 43. Which drug can be used to relieve asthma symptoms? a. Eformoterol b. Tiotropium c. Nedocromil d. Salmeterol e. [salbutamol was NOT on the list] 44. Patient with COPD needs treatment for heart failure. Which is most appropriate? a. Carvedilol b. Perindopril 45. Which drug is most likely to cause orthostatic hypotension? a. Paroxetine b. Moclobemide c. Doxepin d. ? 46. Bupropion is contraindicated in… [ recycled question ] a. Depression b. Epilepsy c. 2 other options 47. Which drug does not have anticholinergic properties? a. Rivastigmine 48. CYP3A4 interactions 49. Child with fever. What’s the best treatment? a. Cool bath b. Fluids c. Regular paracetamol 50. Which drug is suitable for acute gout flares? a. NSAID b. Prednisolone c. colchicine 51. Hydroxychloroquine – which adverse effect is irreversible and warrants monitoring? a. Visual disturbances 52. Lawyer requests patient info. What do you do? [recycled question] a. Give anything required. b. Give anything required, after confirming with patient over the phone. c. Give anything required, upon written consent from patient. 53. Patient was treated with heparin at 1150 units/hour, (25000 units/5mL available). Due to adverse effects (elevated APTT?), the infusion rate was slowed down by 100 units/hour. What is the new infusion rate in mL/hour? 1) Drug most likely to contribute to visual disturbance? Tramadol, digoxin 2) Which regulated restricted drug requires the longest contraception post last dose? Acetretin, Thalidomide, Bosentan, Isotretinoin 3) Which mineralocorticoid effect contributes to side effect of prednisolone? Hypertension 4) Which regulated restricted drug requires contraception 1 month post dose? Thalidomide (isotretinoin was not an option) 5) Patient profile: on furosemide 3 tablets daily, which is the most appropriate option for the way the patient should take the tablet? Take 2 in the morning and 1 and night (other options suggested night time dosing) 6) Which tissue is commonly affected by cytotoxic drugs? Bone 7) Pharmacist wants to copy your answer for CPD, what principle is being broken? Professional autonomy 8) Patient profile: a) experiences akinesia in the morning, already taking levodopa/benserazide qid, what is the most appropriate option? Add a controlled release tablet at 10pm (AMH recommendation) b) patient experiences difficulty swallowing tablet and dr is changing it to a dispersible tablet. This is appropriate, as long as dispersible tablet is the same dose as the current dose c) What is the mechanism of benserazide? Reduce peripheral conversion of levodopa to dopamine 9) Most appropriate advice for threadworm treatment? Treat all household members over the age of 6 months 10) Patient profile: fever in 12 month old (37.5 degrees) what is the most appropriate action? Treat with regular paracetamol 11) Calculations: a) How many g in a 500mL solution if 25mL is added to 500mL to give a 0.025% w/v? b) How many grams of 10% salicylic ointment added to 1300g of 3% ointment to produce 5% ointment? c) Heparin infusion rate at 1150units/min, strength of heparin (25000units/mL). Rate is to be decreased by 100units/min, what is the new rate in mL/minute? d) Oral hydromorphone: oral morphine 3:30; what dose of hydromorphone is equivalent to a current morphine dose of 20mg q4h? e) 400mcg/kg in a 9kg child of 0.1% adrenaline, volume up to 5 mL, how much liquid needs to be added to obtain dose? f) Taking ural 2 sachets qid (each sachet contains 1.76g of sodium bicarbonate) – provided with molar mass of sodium bicarbonate and sodium and required for calculation of total sodium intake 12) Newly prescribed amiodarone, patient profile has simvastatin and other medications, what is the most appropriate action? Contact doctor, change simvastatin to pravastatin 13) Newly prescribed amiloride and hydrochlorothiazide, interacts with what medication? Enalapril (other options I can remember were warfarin) 14) Patient requests steroid inhaler, pharmacy owner always does it without script, best action? Do not supply and refer to doctor 15) Lawyer requests information for one of this clients (your patient), best action? Supply only if provided with written consent by patient to give information to lawyer 16) Isotretinoin monitoring not required? Kidney and thyroid function test 17) Patient profile: hydroxychloroquine, most appropriate monitoring Eye function test 18) Patient taking allopurinol, ACE-I, diuretic, which medication most appropriate for gout flare? Colchicine, prednisolone, NSAID, increase allopurinol dose 20) Which medication least likely to interact with alcohol? Metronidazole, griseofulvin, fexofenadine, sertraline 21) Which medication is patient most likely most sensitive to if they have been diagnosed with Alzheimer’s disease?  few questions asked in different ways regarding anticholinergic drugs and Alzheimer’s disease Anticholinergic medications 22) Organophosphate poisoning, what is the antidote? Atropine 23) Patient profile: Patient with T2DM and other medication conditions a) what is the best treatment for doctor who suspected dermatophyte infection of the nail? Terbinafine tablets, ciclopirox, miconazole cream b) doctor prescribes itraconzole, most likely to interact with? Answer: felodipine, atorvastatin (other options were metformin) 24) What is not included in CHADS2? Alcohol consumption 25) Which combination of medication is least likely to worsen heart failure? ACE-I (other options: thiazolidinediones, non-dihydropyridine calcium channel blockers) 26) Which combination of medications do you usually see prescribed together? Isosorbide mononitrate and amlodipine (other options: beta blocker and diltiazem) 27) Patient profile: patient which osteoporosis, post-herpetic neuralgia and other medical conditions a) Addition of amitriptyline most likely to cause – increase risk of falls b) Most likely medication to be added for neuropathic pain Gabapentin, phenytoin, oxycodone slow release, topiramate 28) Medication used for postural hypotension? Answer: fludrocortisone 29) Patient suffers from gastritis, taking alendronate and other medications; best management option? Increase current antacid to 4 times a day, or stop alendronate – doctor to prescribe omeprazole and review (plus 2 other options) 30) Patient suffers from muscle cramps, most appropriate option? Introduce tonic OR use magnesium OR refer to doctor for review (as patient was taking atorvastatin) 31) Which medication does not interact with COC? Rifampicin, allopurinol, verapamil 32) Patient profile: a) most appropriate action for concrete in the eye: Rinse under water and refer immediately for medication attention b) Patient using chlorsig but develops photophobia and yellow discharge, most appropriate action? Refer to doctor 33) Use of amoxycillin/clav over amoxicillin alone? When resistance is suspected (other options: recurrent otitis externa) 34) Patient has anaphylactic reaction to penicillin, which antibiotic most appropriate for cellulitis? Options: clindamycin, cephalosporins or penicillin 35) Question regarding flucloxacillin dosing? Take on empty stomach for 5 days (the 5 days was specified in the case brief) 26) Medical condition bupropion contraindicated in? Epilepsy 27) Which medication reduces the dose of olanzapine? Valproate 28) Which side effect do you monitor for with clozapine? Agranulocytosis 30) Questions about methotrexate: a) Apart from rheumatoid arthritis, what other condition is it used for? Crohn’s disease b) What are the most appropriate counselling points for methotrexate? If you experience shortness of breath, signs of infection, see your doctor Other options: does not increase sun sensitivity, take before food 31) Not a side effect of tacrolimus? Hypertension, gingival hyperplasia, alopecia, agranulocytosis 32) What is amitriptyline metabolised into? Nortriptyline (other options: imipramine) 33) Which of the following is not a screening program available? (question was something like this) Breast cancer for 55 to 75 years, Colorectal cancer (forgot age range), cervical cancer for over 25 years, prostate cancer for over 30 years 34) What is the bioavailability of acarbose? 1-2%, 4-5%, 7-8%, 14-15%  Danazol - why use contraceptive + getting vocal change - action? Stop and refer  Foods that does not cause heartburn (hint: in APF) o Peppermint o Lettuce o Tomato o onion  COCs interaction does not interacted o Allopurinol o Rifampicin  Dose of enoxaparin VTE tx  Appropriate glaucoma tx o timolol 1 drop bd o latanoprost 1 drop bd  why does clozapine require FBC o bc agran + FBC required at time intervals  Carbamazepine most likely to cause what severe side effects o agranulocytosis  Px migraine tx - amitrip  What is amitrip metabolised into? - nortrip  What are referral symptoms for Vaginal thrush?  Exclusive period for impetigo  Which cancer has a national screening test? o Breast cancer o Prostate in 30+ o Cervical 25+  Which vaccine is in national immunisation prog - Hep B  What side effects are not caused by Tacrolimus? o Hirsutism o Alopecia o Myelosuppression o gingival hyperplasia  Which drug most likely can be harmful in hepatic impairment o Amoxicillin o Fluclox o Trimeth o clarithro  Most significant drug interaction pairs - allopurinol and azathioprine Law Questions: 1. A woman comes into the pharmacy asking for the medication list for her and her husband the her 2 children (who are2 and 6 years old) for taxation. What would you do? a. Give all medication lists to her b. Do not give her anything c. Giver hers only d. Giver hers and her children’s only (I chose this one) 2. Who can prescribe Dronabinol? a. Any prescriber b. Prescriber authorised by the secretary of the commonwealth Department of Health and Aging ( I chose this one as per SUSMP 2020 page 324 Appendix D) c. Prescriber authorised by the secretary of the department of health d. Another option can’t remember. 3. Which option is INCORRECT? a. Brand premium do not count to Safety Net threshold. b. Therapeutic Premiums count to Safety Net Threshold. ( I picked this as per the reference found in the PBS website for “The Safety Net Scheme” which states “brand premiums, therapeutic group premiums and special patient contributions do not count towards the safety net threshold”. c. Safety net benefits apply for the entire supply of Regulation 49 (something like this) 4. A pharmacist wants to copy your answers for her CPD points. What does not action breach? (I forgot the wording) a. Privacy b. Patient Care c. Professional Autonomy ( I chose this one) Therapeutic Questions: A note to future interns: I put the page number of certain medications on the first page of my AMH which helped me save loads of time. The medications I put or should’ve put were: Lithium, Phenytoin, Digoxin, Allopurinol, Amitriptyline. 1. What is NOT a symptom of Amitriptyline overdose: a. Hypertension ( I chose this one as it may cause hypotension not hyper) b. Coma c. Arrhythmias d. Seizures. 2. Which medication is more likely to cause retinopathy? a. Latanoprost b. Hydroxychloroquine (I chose this as per AMH) c. Prednisolone d. Forgot the option. 3. Which medication may cause iris pigmentation? a. Latanoprost (I chose this as per AMH) b. Hydroxychloroquine c. Prednisolone d. Forgot the option. 4. Which medication may cause Cataracts? a. Latanoprost b. Hydroxychloroquine c. Prednisolone (as per AMH) d. Forgot the option. 5. Which medication does NOT exacerbate urinary incontinence? a. Prazosin b. Frusemide c. Amitriptyline d. Allopurinol (I chose this one as per APF (MARK THIS PAGE)) 6. Which medication does NOT have anticholinergic effects? a. Trihexyphenidyl b. Amitriptyline c. Benztropine d. Rivastigmine (I chose this as per AMH) 7. What is a common side effect of Venlafaxine? a. Rash (I chose this as per AMH) b. Seizures c. Hypernatremia d. Diarrhoea 8. Patient Profile: Patient’s child (2 years old) has fever (37.5 degrees) a. Which option is the best option for this child? i. Giving paracetamol and ibuprofen is the best (“combining paracetamol and ibuprofen to treat fever is not recommended” AMH) ii. Give prophylaxis anticonvulsant to prevent febrile seizures iii. Do not do anything iv. Give fluids for hydration (I chose this option as per AMH. It states that children who have a fever less then 38 degrees “often respond to fluids and may not need paracetamol”) b. Which statement is incorrect? i. Febrile seizures occur in about 3% of children ii. Patient should be given paracetamol to prevent febrile seizures (I chose this as per AMH). iii. Forgot 9. Which food would not contribute to reflux or stomach ulcer (forgot the wording)? a. Tomato b. Lettuce c. Chocolate d. Coffee 10.Which is least likely to exacerbate psoriasis? e. Mild sun exposure (I chose this) f. Some medications g. Stress 11.which medication is most likely to have worsened the patient’s psoriasis? - forgot the options but the answer was lithium as per AMH 12. the patient wants to quit smoking. He is a heavy smoker (more then 20 in a day). He is on methadone and is also and alcoholic. He has cirrhosis. Which option is best to help his condition? - buproprion (not for people who abuse alcohol and cirrhosis) - Varenciline (I forgot why this was wrong but it was definitely not recommended. Maybe he had a history of seizure? Don’t know) - Nicotine patch 21mg ( I chose this) - Nicotine patch 14mg OTHERS: a lot of drug interaction questions especially with combined oral contraceptives so make sure you mark that page. Calculations: 1. Patient is on a medication. dose of 6.25mg every 4 to 6 hours for 3 days. What is the maximum daily dose this patient? a. 112.5mg b. 37.5mg ( chose this) c. 25mg d. 3.7grams 2. Patient is taking 2 sachets of URAL 3 times daily. Sodium bicarbonate (MW 84.01) in 1 sachet is 1.45grams. How much sodium (MW 22.99) is the patient taking in 1 day. a. 0.397grams b. 39.7grams c. 2.38grams ( chose thise) d. 2.38 mg 3. Some other dilution questions which were quite basic 4. No crcl or BSA or BMI 5. No C1v1=c2v2 6. A LOT OF MICROG TO MG be careful!!!!!!!!!! FEBRUARY 2020 APC EXAM RECALLS Law and Ethics A regular customer came in and ask for a steroid puffer for his asthma, he said that your proprietor normally gives him the puffer without a script as he does not want to see the doctor as it would incur cost. What would you do? Dispense the steroid puffer with instruction label Inform the customer you cannot give him the puffer and tell him to see his doctor Something about which one is routinely screened? Colorectal cancer screening Breast cancer screening Cervical cancer screening Prostate cancer screening How long should you receive the physical prescription for S4 medicine after a confirmed phone order? 7 days Who cannot write repeat prescription? Dentist Which option is the INCORRECT way of handling confidential waste: Use a shredding machine and put them in the waste bin Shred materials and place in a sealed bag and put it the waste bin Use one of the approved shredding services… Tear them into small pieces so that people cannot read and put them in the waste bin (not sure of this one, but chosen the last option) Who can prescribe thalidomide? Dermatologist Psychiatrist Haematologist Xxxxx Which of the following medication must be prescribed by a psychiatrist? Dexamfetamine Dexamethasone Xxxx xxxx The customer has given returned medicines, what should you do: Receive the medicines and put them in the RUM bin and dispose according (something like that) Receive the medicines and save them for staff use if they are still in date Receive the medicines, put them in the RUM bin, but later take the ones still in date out for dispensing Collect the medicines and donate to charity Calculation Patient was on heparin 1150U/hour, the medicine contains 25000U/100mL. Patient’s dose is now reduced to 1050U/hour. How many mL is the patient is with the new dosing regime? A 5 year old child of average weight is requiring paracetamol. What dose should he be getting every 4 to 6 hours? A patient is on a medicine at a dose of 2.5mg/kg/day in 2 divided doses for 3 days. The patient is 8kg. How many mg is the patient on ? (may not be the exact question) A child/ patient is on prednisolone 1mg/kg once daily for 3 days. Predmix comes in 5mg/mL, the dose (could have been total dose over 3 days, did not state very clearly) was 14.4mL. How many kg was the patient? One question was about rate of infusion mL/min, total of 100 mL , infused over 20 minutes, once every 6 hours for 3 days A solution of 1:50000 if x mL was used, what is the amount of drug in xmL? A question about an anticancer treatment at a particular dose, once a week and have 1 week off in between. The complete course takes 26 weeks. The tablet comes in 2.5mg each. How much tablets is required to complete the 26 weeks of treatment? Drug knowledge and therapeutics Areas mainly tested on: respiratory, anti-infectives, dengy fever, causative pathogens gastroenteritis, pharyngitis with Strep pyogenes cardiovascular; hear failure, arrhythmias, Psych: antidepressants, antipsychotics, Osteoarthritis, Rheumatoid Arthritis, Gout acute flare management T2DM Question regarding drug interactions: Digoxin Warfarin Amiodarone Lithium Macrolides Phenytoin Sildenafil vs one of the alpha blocker St John’s wort Which opioid is LEAST like to cause serotonin syndrome? Fentanyl Tramadol Morphine Dextromethorphan What laxative would you use for opioid induced constipation? Bulk forming agent Docusate alone Osmotic laxative containing sorbitol Magnesium containing laxative What advice would you give if the patient is taking methotrexate the first time? What advice would you give if the patient is taking clozapine the first time? What medication causes EPSE? What medication causes EPSE, particularly dystonia? Option included metoclopramide Choose the MOST appropriate option in regarding therapy for insomnia: Elderly patients with chronic insomnia should be treated with non-pharmacologic interventions Benzodiazepine with long half-life often used in the treatment of chronic insomnia Which of the following option is MOST appropriate: Budesonide and fluticasone are of equal potency Fluticasone has less effects on adrenal suppression compared to other corticosteroids therefore is used in children Can’t remember the other 2 options Which topical steroid is the most potent out of the following options? Betametasone dipropionate 0.05% Hydrocortisone Desonide Clobetasol (0.05%) shampoo Which topical steroid cream/ointment should not be used on the face? Betametasone dipropionate What side effect would you expect an 80 year old on fluvastatin 80mg? Drowsiness Confusion Myopathy Xxx What advise would you give to a patient stating on simvastatin? Should only be taken at night time Diet modification reduces 60% of cholesterol… Ezetimibe reduces …% cholesterol Which of the following medication is first line for Major depression? Reboxetine Mirtazepine Moclobenmide Mianserin Which medication is first line for OCD? Which medication would you use in 1st gout flare? Lab results show serum creatinine is double the normal range Prednisolone 20mg daily Colchicine 500mg every 6 hours Naproxen … Paracetamol Something about probenecid A patient has missed her period for 3 weeks, she may be pregnant and need some information about her medicines, if they are safe during pregnancy She is on: doxycycline multivitamins Sertraline Thyroxine Another patient profile patient on sertraline 100mg daily. Just has a total knee replacement and on pain killers Paracetamol and tramadol 50mg ; 2 caps QID What would you be querying about ? I think it was the risk of serotonin toxicity (tramadol and sertraline combo) Patient has T2DM and on lots of other meds for other conditions BSL is very high HBA1c is very high too Lab data shows highly elevated liver enzymes What would you use to control his blood sugar level? Metformin Gliclazide What advise would you give when patient is on acarbose? What medication require label 1? Which medication is not associated with antidiuretic hormone ? Hydrochlorothiazide?? The difference between ACE inhibitors and sartans? ACE inhibitors also inhibits the breakdown of bradykinin whereas sartan does not What medication may cause constipation? All I can remember was verapamil Which of the following medication does not cause taste disturbances? Which medication is most likely to cause first dose orthostatic hypotension? One of the option was prazosin How does selective alpha blockers work to relieve symptoms of BPH? Cold sore treatment – what dose and duration of acyclovir is required for patients who is on methotrexate 15mg once a week? Pharyngitis with Strep. pyogenes which antibiotics most likely to be prescribed, patient is not allergic to anything Severe sore throat treatment Paracetamol Nurofen Tramadol Which pathogen is LEAST like to cause gastroenteritis? Rotavirus Samonella p Typhoid Lactobacillis … What treatment would you give to a patient who has gastroenteritis? All the fluids options A patient is suffering from gastroenteritis. The carer forgot to leave you fluids to give. What would you give the patient if you have on hand the following A fizzy “soft drink” Sport drink Plain water Fruit juce What advice would you give to patient who is on lithium? Which vitamin is water-soluble? Vitamin A Vitamin K2 Vitamin B6 Vitamin D Which NSAIDs is least likely to cause GI upset? Celecoxib Piroxicam Diclofenac Ibuprofen A patient has uncontrolled asthma On salbutamol 2 qid prn Fluticasone 125mcg bd What would you do? Add ipratropium daily Add montelukast 10mg daily Change to a combination of fluticasone + salmetarol 250/50 Oral prednisolone or something like that COPD Smoking cessation has significant improvement of lung function – or something like that Which medicine is non-cytotoxic? Bleomycin Methotrexate Fluoracil Ciclosporin Which side effect is not associated with anti-androgen ? Patient is on goserelin for Prostate Cancer. What is the purpose of taking flutamide; an anti- androgen concomitantly? suppress tumour flare Drugs that worsen parkinsonism ? What medicine is used in community acquired pneumonia? Which is the longest insulin? Glargine Aspart Glulisine Lispro What drug is used for glaucoma? Note: patient has asthma Latanoprost Nitrate and prazosin = worsen hypotension Which medication could have worsen the patient’s heart failure? Something about itraconazole absorption affected 1. Longest acting insulina. Isophane b. Glargine 2. Benzodiazepine : app ropriate: a. Elderly on benzo b. Short acting benzo.. 3. St. John’s wor t interaction :NOT A. Echinacea B. Rifampicin 4. Which one is the least likely to have anticholinergic effects a. Rivastigmine b. Amit riptyline c. Benzhexol d. Iprat ropium 5. Indicated in OCD Fluoxetine 6. Which one is not cytotoxic a. Bleomycin b. Ciclospo rin c. Metho trexate d. Fluorouracil 7. Can cause EPSE : metoclopramide 8. Opioid constipation: a. Docusate only b. Stimulant laxative 9. Sumat riptan :with uncont rolled hypertension 10. Tacrolimus NOT common side effect a. Alopecia b. Myelosuppression 11. Biphosphonates: NOT app ropriate: a. Taken orally and daily at limited time 12. Fat soluble vitamins a. Vit b 6 b. Vit a c. Vit d 13. Which causes parkinsonism like medication a. Risperidone 14. Gast roenteritis caused by rotavirus 15. Not used for nausea: a. Chlorpromazine b. Citalop ram c. Metoclopramide 16. Paroxetine 17. Label 1 a Except: a. Carbamazepine b. Clomipramine 18. Profile : Sertraline with t ramadol and MTX; which one are you going to refer 19. Acarbose common side effect: diarrhoea 20. Profile: digoxin : digoxin level is 2mcg, so not yet as toxic level; question is, what is the side effect that the patient is experiencing with this. a. Seizu re b. Confusion c. ano rexia 21. Profile : Ramipril : asking what analgesic med can be used : a. Diclofenac (I didn’ t choose this, due to interaction) 22. Expired medication what to do a. Check if the details are cor rect, apologize and call the docto r immediately 23. Ace inhibitor and sartan: app ropriate: a. Ace inhibitor breaks down bradykinin and sartan does not 24. Breast feed: app ropriate: a. Take the medicine af ter breastmilk b. Take the medicine before breastmilk c. Medicine is not usually secreted in milk supply 25. ETHICS : Pharmacy stationery scripts how to dispose:NOT app ropriate a. Tear into pieces by hand b. Seal in an envelope and throw it in bin to be collected daily c. Shred, Dispose in a bin Privacy agreement with the company 26. EPSE overdose : use benzt ropine 27. Profile: Salmeterol (in Intern sample 1, page 54, and question number 124. a. Add salmeterol 50 mcg 2 puffs bd 28. Digoxin and fluconazole interaction 29. ETHICS : Owner of the pharmacy usually supply a patient with a cor ticosteroid int ranasal spray without script and she wants more, what should you do? a. Refuse to supply and refer to GP 30. Alpha antagonist : TRUE a. Increase urine out flow b. Cause hypertension c. More side effects the longer you take 31. Profile: Galactorrhea caused by : A. antidepressant that she is taking B. increased levo thyroxine C. decreased levo thyroxine 32. Tu rbuhaler: TRUE a. hold vertical while loading b. hold vertical when inhaling c. shake well 33. Profile: Phenytoin 1 cap BD a. Phenytoin 100mg mane and 130 at night b. Phenytoin 200mg mane and 200mg at night 34. NOT use in the face without medical supervision: a. Betamethasone b. Hydrocor tisone 35. Most potent steroid topically a. Clobetasol shampoo b. Betamethasone dipropionate 36. Not af fected by SIADH 37. Use of flutamide with goserelin 38. Mineralcorticoid effects of prednisolone: hypertension 39. First line for major depression: a. mirtazapine b. SSRI 40. Profile : alt and ast are above normal values ; asking for what pain medication can be given, I didn’ t choose paracetamol/codeine, coz liver enzymes were already increased. The profile is like in the intern sample 2 but the question was just different. Since the patient in that profile has a liver disease, and says be careful with paracetamol 41. Paracetamol for 5 years old, no weight given : a. 125mg every 4-6h, b) 250mg q4-6 42. Profile Heart failure medications: asking what side effect is the patient having a. Angioedema 43. Best for croup in child ren a. Co-amoxiclav b. Humidification 44. Carbamazepine NOT used in absence seizure 45. Psoriasis not agg ravated by mild sun exposure 46. Lower gast rointestinal side effect: diclo fenac 47. Lithium and NSAIDs diclo fenac was one of the choices 48. Prophylaxis anti-arrythmic for patient who had MI a. verapamil b. flecainide c. metop rolol 49. Aust ralia doesn’ t have screening test for : (with age group) a. Breast cancer b. Cervical cancer c. Prostate cancer 30years old 50. Should be prescribed by Psychiat rist: a. Dexamphetamine 51. LAW: Telephone order by the docto r for s4 how many days should the be sen t? Answer: 7 Days 52. LAW: Thalidomide prescribed by: haematologist 53. Foam dressing: promote a moist environment (APF) 54. Isoniazid peripheral neuropathy can be t reated by vitamin b6(pyridoxine) 55. What fluids can be given to the patient: a. Sports drink b. Plain water c. Fruit juice 56. Acu te gout crcl 10 ml/min a. colchicine b. prednisone 57. Promotes excretion of uric acid : probenecid 58. Glandular fever EXCEPT: a. exclusion for 14 days b. Epstein barr virus 59. Fluoxetine inhibited by CYP2d6 60. Warfarin interactions 61. Best for S. pyogenes ---a. phenoxymethypenicillin 62. Gentamicin t reats a. gram positive b. gram negative c. anaerobes. d. other organisms 63. Acyclovir for cold sores : 400mg tid for 5 days 64. Patient: Immunisation for patient had an operation, has pneumonia before a. Influenza b. Tetanus c. Hepa b 65. SSRI which doesn’ t have interaction with this a. Omeprazole 66. 15 minutes before meal 67. A. lercanidipine 68. Colchicine maximum dose in 3 days------- 1.5mg 69. Minimize the systemic adverse effect of eye drops: application of pressure in the tear duct can minimize the risk 70. Oin tments are for dry and scaly 71. Therapeutic drug monitoring NOT TRUE : 72. Amiodarone : NOT TRUE a. Long half life 73. Carbamazepine increases warfarin metabolism ; less anticoagulant effect 74. BP of 150/90 a. Sartan 75. It raconazole and simvastatin interaction 76. has interaction: MOST: a. haloperidol + b. haloperidol+ c. sodium valproate+ d. ephedrine +MAO 77. NO Serotonin syndrome a. Tramadol b. Fentanyl c. Dext romethorphan d. Morphine 78. Profile: Asthma with glaucoma what to use a. Timolol b. Latanoprost 79. Sertraline and levo thyroxine pregnancy questions a. both are safe for the first t rimester 80. Sertraline withdrawal effects with baby 81. Patient profile asking what medication to use :patient has heart failure and complicated health condition one of the choices were add spironolactone 25mg 82. COPD : stop smoking 83. Hba1c – evry 3 months 84. Profile: what to use for pneumonia when he goes out of hospital He has heart problems a. Doxycycline b. Azithro c. Clarith ro 85. Causes constipation : Verapamil 86. Counselling for Simvastatin : TRUE : a. to take at night 87. bleeding : a. misoprostol 88. Profile : increased blood glucose , what to add A. Met formin B. Gliclazide 89. Not a symp tom of chicken pox a. Headache b. Fever 90. Fluvastatin 80mg tab what is the side effect: a. myalgia 91. LAW: Cannot write repeats for PBS script : a. dentist 92. Amiodarone : TRUE a. photosensitivity 93. ICS : True : a. Fluticasone equipotent to budesonide b. Cause hoarse voice in people with oral thrush 94. Least to cause sero tonin syndrome a. Fluoxetine and dext ro b. Fluoxetine and lithium c. Dext ro+ phenelzine d. Dext ro + codeine (this was in intern sample 1) 95. Not used for motion sickness a. Promethazine b. Hyoscine c. Metoclopramide 96. Sildenafil con traindicated in: a. Isosorbide dinit rate 97. Folic acid to reduce the side effects of MTX 98. Diarrhoea child ren 99. Biphosphonates : inflammation of the esophagus 100. Calculation Asking for the patients weight. the volume of the medication per dose was given. The suspension 100ml of was 2mg/ml Choices: a. 18kg, b. 24kg c. 30kg 101. Heparin dosing question. 1150 ml/ hr, 2500 units/ml, slowed down by 100/hour Choices a. 2.1ml b. 21 ml c. 23ml 102. Omeprazole prescribed as 1mg/kg/day in three divided doses. weight of the patient is 9kg. how much should be given per dose? Answer is 1.5ml 103. Potassium permanganate the answer was 4000ml.. the choices were a. 400ml B. c. d. one tablet is to 4000ml 104. 2 % w/v in to (volume) answer is 50g 105. Chemo drug , the patient’ s weight was given, then the dose per two weeks which is 2.5mg/kg. How many 2.5mg tablets should be used in 28 weeks??? Answer : 260 tablets 106. Dilution question like in intern sample sample calculation : the answer is 90ml 107. Infusion rate 400mg in 100ml , run in 20 minutes for every 6 hours for 3 days 108. Which of the following is water soluble vitamin: vitamin b 109. Which one of the following least likely to af fect the effectiveness of COC: echinacea 1. Longest acting insulin- a. Isophane b. Glargine 2. Benzodiazepine : appropriate: a. Elderly on benzo b. Short acting benzo.. 3. St. John’s wort interaction :NOT A. Echinacea B. Rifampicin 4. Which one is the least likely to have anticholinergic effects a. Rivastigmine b. Amitriptyline c. Ipratropium d. 5. Indicated in OCD Fluoxetine 6. Which one is not cytotoxic a. Bleomycin b. Ciclosporin c. Methotrexate d. Fluorouracil e. 7. Can cause EPSE : metoclopramide 8. Opioid constipation: a. Docusate only b. Stimulant laxative 9. Sumatriptan : NOT to use in MI, uncontrolled hypertension 10. Tacrolimus NOT common side effect a. Alopecia b. Myelosuppression 11. Biphosphonates: NOT appropriate: a. Taken orally and daily at limited time 12. Fat soluble vitamins a. Vit b 6 b. Vit a c. Vit d 13. Which causes parkinsonism like medication a. Risperidone 14. Gastroenteritis caused by rotavirus 15. Not used for nausea: a. Chlorpromazine b. Citalopram c. Metoclopramide 16. Paroxetine 17. Label 1 a Except: a. Carbamazepine b. Clomipramine 18. 19. Profile : Sertraline with tramadol and MTX; which one are you going to refer 20. Acarbose common side effect: diarrhoea 21. Profile: digoxin : digoxin level is 2mcg, so not yet as toxic level; question is, what is the side effect that the patient is experiencing with this. a. Seizure b. Confusion c. anorexia 22. Profile : Ramipril : asking what analgesic med can be used : a. Diclofenac (I didn’t choose this, due to interaction) 23. Expired medication what to do a. Check if the details are correct, apologize and call the doctor immediately 24. Ace inhibitor and sartan: appropriate: a. Ace inhibitor breaks down bradykinin and sartan does not 25. Breastfeed: appropriate: a. Take the medicine after breastmilk b. Take the medicine before breastmilk c. Medicine is not usually secreted in milk supply 26. ETHICS : Pharmacy stationery scripts how to dispose:NOT appropriate a. Tear into pieces by hand b. Seal in an envelope and throw it in bin to be collected daily c. Shred, Dispose in a bin Privacy agreement with the company 27. EPSE overdose : use benztropine 28. Profile: Salmeterol (in Intern sample 1, page 54, and question number 124. a. Add salmeterol 50 mcg 2 puffs bd 29. Digoxin and fluconazole interaction 30. Alpha antagonist : TRUE a. Increase urine outflow b. Cause hypertension c. More side effects the longer you take 31. Profile: Galactorrhea caused by : A. antidepressant that she is taking B. increased levothyroxine C. decreased levothyroxine 32. Turbuhaler: TRUE a. hold vertical while loading b. hold vertical when inhaling c. shake well 33. Profile: Phenytoin 1 cap BD a. Phenytoin 100mg mane and 130 at night b. Phenytoin 200mg mane and 200mg at night 34. NOT use in the face without medical supervision: a. Betamethasone (AMH) b. Hydrocortisone 35. Most potent steroid topically a. Clobetasol shampoo b. Betamethasone dipropionate 36. Not affected by SIADH , a. desmopressin b. hydrochlorothiazide c. 37. Use of flutamide with goserelin 38. Mineralcorticoid effects of prednisolone: hypertension 39. First line for major depression: a. mirtazapine b. SSRI 40. Profile : alt and ast (lab values)are above normal values ; asking for what pain medication can be given,  I didn’t choose paracetamol/codeine, coz liver enzymes were already increased.  The profile is like in the intern sample 2 but the question was just different. Since the patient in that profile has a liver disease, and says be careful with paracetamol 41. Paracetamol for 5 years old, no weight given : a. 125mg every 4-6h, b) 250mg q4-6 42. Profile Heart failure medications: asking what side effect is the patient having a. Angioedema 43. Best for croup in children a. Co-amoxiclav b. Humidification 44. Carbamazepine NOT used in absence seizure 45. Psoriasis not aggravated by mild sun exposure 46. Lower gastrointestinal side effect: diclofenac 47. Lithium and NSAIDs diclofenac was one of the choices 48. Prophylaxis anti-arrhythmic for patient who had MI a. verapamil b. flecainide c. metoprolol Anti-arrhythmic: AMH 2018 page 288 Preventive treatment: consider long term prophylaxis with verapamil or beta blockers except Sotalol. ***Im not quite sure if in the profile the patient was on beta blocker already or not. Verapamil is contraindicated with beta blockers. 49. Australia doesn’t have screening test for : (with age group) a. Breast cancer b. Cervical cancer c. Prostate cancer 30years old 50. Foam dressing: promote a moist environment (APF) 51. Isoniazid peripheral neuropathy can be treated by vitamin b6(pyridoxine) 52. What fluids can be given to the patient: a. Sports drink b. Plain water c. Fruit juice 53. Acute gout crcl 10 ml/min a. colchicine b. prednisone 54. Promotes excretion of uric acid : probenecid 55. Glandular fever EXCEPT: a. exclusion for 14 days b. Epstein barr virus 56. Fluoxetine inhibited by CYP2d6 57. Warfarin interactions 58. Best for S. pyogenes ---a. phenoxymethypenicillin 59. Gentamicin treats a. gram positive b. gram negative c. anaerobes. d. other organisms 60. Acyclovir for cold sores : 400mg tid for 5 days 61. Patient: Immunisation for patient had an operation, has pneumonia before a. Influenza b. Tetanus c. Hepa b 62. SSRI which doesn’t have interaction with this a. Omeprazole 63. 15 minutes before meal A. lercanidipine 64. Colchicine maximum dose in 3 days------- 1.5mg 65. Minimize the systemic adverse effect of eye drops: application of pressure in the tear duct can minimize the risk 66. Ointments are for dry and scaly 67. Therapeutic drug monitoring NOT TRUE : 68. Amiodarone : NOT TRUE a. Long half life 69. Carbamazepine increases warfarin metabolism ; less anticoagulant effect 70. BP of 150/90 a. Sartan 71. Itraconazole and simvastatin interaction 72. has interaction: MOST: a. haloperidol + b. haloperidol+ c. sodium valproate+ d. ephedrine +MAO 73. NO Serotonin syndrome a. Tramadol b. Fentanyl c. Dextromethorphan d. Morphine 74. Profile: Asthma with glaucoma what to use a. Timolol b. Latanoprost 75. Sertraline and levothyroxine pregnancy questions a. both are safe for the first trimester 76. Sertraline withdrawal effects with baby 77. Patient profile asking what medication to use :patient has heart failure and complicated health condition one of the choices were add spironolactone 25mg 78. COPD : stop smoking 79. Hba1c – evry 3 months 80. Profile: what to use for pneumonia when he goes out of hospital He has heart problems a. Doxycycline b. Azithro c. Clarithro 81. Causes constipation : Verapamil 82. Counselling for Simvastatin : TRUE : a. to take at night 83. bleeding : a. misoprostol 84. Profile : increased blood glucose , what to add A. Metformin B. Gliclazide 85. Not a symptom of chicken pox a. Headache b. Fever 86. Fluvastatin 80mg tab what is the side effect: a. myalgia 87. LAW: Cannot write repeats for PBS script : a. dentist 88. Amiodarone : TRUE a. photosensitivity 89. ICS : True : a. Fluticasone equipotent to budesonide b. Cause hoarse voice in people with oral thrush 90. Least to cause serotonin syndrome a. Fluoxetine and dextro b. Fluoxetine and lithium c. Dextro+ phenelzine d. Dextro + codeine (this was in intern sample 1) 91. Not used for motion sickness a. Promethazine b. Hyoscine c. Metoclopramide d. Domperidone 92. Sildenafil contraindicated in: a. Isosorbide dinitrate Drug Interaction Details: Coadministration of phosphodiesterase type 5 (PDE-5) inhibitors and antianginal nitrates may cause additive hypotensive effects via potentiation of nitric oxide (NO)- induced vasodilatory action. Studies in angina patients and healthy volunteers reported significant reductions in blood pressure with combined use. In addition to this, reports of sildenafil-related fatalities have included several patients who had also taken an antianginal nitrate. This combination is contraindicated due to its potentially life-threatening risk of severe hypotension, or even myocardial infarction. In situations where a nitrate is clinically indicated, a transfer period is required after the last dose of PDE-5 inhibitor. Consult product literature for specific recommendations. (EMIMS) 93. Folic acid to reduce the side effects of MTX 94. Diarrhoea children 95. Biphosphonates : common side effect: inflammation of the esophagus 96. Foam dressings/film dressings: TRUE : a) promote moist wound healing environment 97. Urinary incontinence (APF) 98. Taste disturbance : which of the following does not have this side effect. 99. Levothyroxine : TRUE a.) if you feel palpitations refer to GP b) lethargy 100. Does not need antibiotics: a. gastroenteritis b. impetigo Note: I answered gastroenteritis since it will resolve on its own 101. Methotrexate: TRUE 102. Alternative for metoprolol for diabetic patients : carvedilol (AMH 2018 page 275) Beta 1 selective beta blocker (metoprolol) and beta blcokers with alpha blocking activity (carvedilol) are preferred because they are safe and effective in type 2 diabetes 103. Increased blood glucose : a. prednisolone 104. MU receptor in gut for constipation of opioid LAW AND ETHICS 1.) ETHICS : Owner of the pharmacy usually supply a patient with a corticosteroid intranasal spray without script and she wants more, what should you do? a. Refuse to supply and refer to GP 2. ) Expired medication what to do a. Check if the details are correct, apologize and call the doctor immediately 3.) Should be prescribed by Psychiatrist: a. Dexamphetamine 4.) LAW: Telephone order by the doctor for s4 how many days should the be sent? Answer: 7 days 6.) LAW: Thalidomide prescribed by: haematologist 7.) ETHICS : Pharmacy stationery scripts how to dispose:NOT appropriate a. Tear into pieces by hand b. Seal in an envelope and throw it in bin to be collected daily c. Shred, Dispose in a bin Privacy agreement with the company 8.) Label 1 a Except: a. Carbamazepine b. Clomipramine Calculation: 1.) Asking for the patients weight. the volume of the medication per dose was given. The suspension 100ml of was 2mg/ml Choices: a. 18kg, b. 24kg c. 30kg 2.) 1150 ml/ hr, 2500 units/ml, slowed down by 100/hour Choices a. 2.1ml b. 21 ml c. 23ml 3.)Omeprazole prescribed as 1mg/kg/day in three divided doses. weight of the patient is 9kg. how much should be given per dose? Answer is 1.5ml 4.)Potassium permanganate the answer was 4000ml.. the choices were a. 400ml B. c. d. one tablet is to 4000ml 5.)2 % w/v in to (volume) answer is 50g 6.)Chemo drug , the patient’s weight was given, then the dose per two weeks which is 2.5mg/kg. How many 2.5mg tablets should be used in 28 weeks??? Answer : 260 tablets 7.)Dilution question like in intern sample sample calculation : the answer is 90ml 8.) Infusion rate : for 400mg in 100ml , run in 20 minutes for every 6 hours for 3 days 1. 30mg prednisolone for three days, then reduced by 5mg every three days, what is the number of 25mg tabs and 5 mg tabs? 2. Was 1150 UI/min, then reduced by 100UI/min, the concentration is 25000IU/500ml, what is the current rate in ml/min? 3. How many g of ointment A 10%, mixed with 1800g ointment B 3%, the final concentration is 5%? 4. ibuprofen 400 or less, 50 tabs or less, what schedule? 5. Cannabis need to be approved by: department of health and ageing 6. What cannot worsen HF: ACE inhibitor 7. Fungal nail symptoms : A. thickening B. shinny and lustrous C. over growth D… 8. Fungal nail treatment: terbinafine 9. Chickenpox symptoms not include: A. fever B. joint pain C. sore throat D. headache 10. Cautionary labels for cyclosporine and mycophenolate. 11. heavy bleeding cause? (Patients on some medications, 32 age, regular alcohol drinker) 12. same patient heavy bleeding treatment ? A. ibuprofen 400 2cap three times a day. B… C… D. COC 13. same patient, what is the least option for her bleeding: A.NSAIDs B. COC. C. goserelin D. progesterone 14. same patient, what is the reason for fatigue: A iron loss (due to blood loss?) 15. gooseling treatment duration: 6months 16. least cause of reflux: A. lettuce B. Tomato C. onion D. pepper mint oil 17. isoniazid cause neuropathy, need to take : Vitamin b6 18. if a customer does not use their information for my health record: explain the risk of excluding information and apply their requirement 19. who cannot write repeat PBS: dentist? 20. Least likely to cause fall in the elderly: A. TCA B. antiarrhythmic C. Antihypertensive D. glitazon 21. Impetigo exclude duration: once antibiotics stated 22. Patient has RA, the reason for persist cough: A. allopurinol Methotrexate 23. Which one is disease modified agent: A. allopurinol B. leflumomide 24. How many g of X dissolved in 500ml, get 25ml from this solution, diluted to 500ml, the final concentration is 0.025%?(numbers may not right) 25. Venlafaxine change to phenelzine: 2days 26. Lawyer ask for information: written consent form patient 27. Least side effects of gold salts: constipation 28. The patient was on both cyclosporine and diltiazem, but he has numbness in his arm and legs. What to do? A. decrease dose of cyclosporine B. change diltiazem dose C…D… 29. PBS streamline authority: dabigatran 30. Least for post MI: amlodipine 31. The least side effect of prednisolone: A. urinary incontinence B. increased ocular pressure C. increased blood sugar level. D. electrolytes disturbance 32. Which one is not in national screen: prostate cancer 33. Which on cause nightmare: statin 34. Which one is suitable for diabetic patient with microalbunuria: ACE inhibitor 35. Which one is ok in renal impairment: prednisolone 36. A child has diahrria, carer does not have rehydration fluid, what should give: plain water? 37. Which one is most appropriate: A. gastro do not need to be investigated in most children. B… C…D. clear water is ok for first day… 38. A pregnant lady is on methadone, wants to quit smoking: A. refer to dr for bupropion. B. NRT 39. Which one is not the sign of EPSE: hypotension 40. A patient is on digoxin, got a script of erythromycin, what to do: contact dr change to different antibiotics 41. Pregnant lady with UTI treatment 42. The symptoms of thyroid 43. The interaction between pravastatin and cyclosporine: decrease dose of pravastatin. 44. Which one is not the symptoms of TCA overdose: hypertension 45. Oral typhoid vaccine cannot be used with: doxycycline 46. Insulin isaphen can be used without regard to food 47. Initial treatment for glaucoma: timolol drops BD 48. Diabetic patient asks you about corn treatment: refer to podiatrist 49. A customer has HTN and another medication about BPH? ask for something to treat allergic retinitis: A. pseudoephedrine B. oxymetazoline C. fexofenadine 60TID Steroid nasal spray 50. Patient started the LAMA/LABA, what to do with the other medication: A. frusemide change dose B. stop using salbutamol/ ipratropium C. still use salbutamol/ ipratropium but prn D… 51. Rifampicin side effect: stain soft contact lenses 52. Bets for opioids caused constipation: senna+cloxyle 53. Bets for opioids caused constipation: (no Senna as option) osmotic –sorbitol 54. Coc has least interaction with: echiacea 55. What is the most serious side effect of ACE inhibitor: angioedema 56. For 5 year old child, How to use spacer and how to clean: A. soapy water and rinse B. a small spacer is better. C. cannot used for both steroid and salbutamol. D… 57. what to start for an obese after diet modification: A. biguanide(=metformin) 58. least for post MI: A. adenosine B. heparin C. aspirin D. bivalirudin 59. least for rebound headache: A opioids, B. TCA C. sumatriptan D… 60. clozapine: agranulocytosis 61. carbemazole: agranulocytosis 62. which one does not cause neutrophilponia: 63. least likely to cause reflux or heartburn: A lettuce B. tomato C. onion D. peppermint oil 64. Dementia patient most sensitive to: anti-cholinergic medicine Question 1 Not yet answered Marked out of 1 After a 100 mg IV dose, the blood concentration result came back as 2.7 micrograms/mL. What is the apparent volume of distribution? Select one: A. 37 L B. 37 037 L C. 370 L D. 370 mL A. 37 L Correct! Vd = Dose/Cp0 = 100 mg/ 2.7 mcg/mL = 100 mg/ 2.7 mg/L = 37 L Remember: Half-life t1/2 = 0.693/kel Where t1/2 is the half-life and kel is the elimination rate constant. Apparent volume of distribution Vd Vd = Dose/Cp0 Where Vd is the apparent volume of distribution (L), dose is the amount of drug given (mg), and Cp0 is the initial plasma concentration (mcg/mL). Question 2 Not yet answered Marked out of 1 Question text Calculate the body surface area using the ideal body weight for a 182 cm male of average build. Select one: A. 1.9 B. 2.0 C. 1.5 D. 1.2 B. 2.0 Correct! IBW = 50 kg + (0.9 kg x 30) = 77 kg BSA using 77 kg = 2.0 cm2 Remember - IBW: Females – 45.5 kg + 0.9 kg/cm for each cm >152 cm Males – 50 kg + 0.9 kg/cm for each cm >152 cm BSA (m2) = √ (height (cm) x weight (kg) ---------------------------------- 3600 Question 3 Not yet answered Marked out of 1 Question text A child aged 2 years, weighing 10.5 kg has been prescribed amoxycillin 250mg/5mLTDS. Calculate the volume per dose, if the recommendation for amoxycillin is 15mg/kg 8 hrly. Select one: A. 1.6 mL B. 3.2 mL C. 2.1 mL D. 4.0 mL B. 3.2 mL Correct! Dose = 15 mg x 10.5 kg = 157.5 mg Amoxycillin 250mg/5mL – 157.5 mg in 3.2 mL Question 4 Not yet answered Marked out of 1 Question text Assuming that first-order kinetics occur, calculate the half-life of Drug B, which is eliminated from the body at a rate constant of 25% per hour. Select one: A. 46 min B. 12 hours C. 2.8 hours D. 4.6 hours Not 12 hours Remember: Half-life t1/2 = 0.693/kel Where t1/2 is the half-life and kel is the elimination rate constant. Apparent volume of distribution Vd Vd = Dose/Cp0 Where Vd is the apparent volume of distribution (L), dose is the amount of drug given (mg), and Cp0 is the initial plasma concentration (mcg/mL). Question 5 Not yet answered Marked out of 1 Question text 500 mL of 5% Dextrose is to be administered over 4 hours. Calculate the rate of infusion in mL/hr. Select one: A. 150mL/hr B. 100 mL/hr C. 50 mL/hr D. 125 mL/hr Not 50ml/ hr Question 6 Calculate the initial allopurinol dose for Mr JB who is 62 years old, weighs 78 kg and his serum creatinine is 430 micromol/L. The initial daily dose of allopurinol is 100 mg once daily, if CrCL 152 cm BSA (m2) = √ (height (cm) x weight (kg) ---------------------------------- 3600 BMI= weight (kg) --------------- height (m)2 Question 15 Not yet answered Marked out of 1 Question text What would be the strength of zinc oxide ointment if you prepared 90 g of an ointment that contained 5 grams of zinc oxide? Select one: A. 1.8% w/w B. 5.6% w/w C. 9.0% w/w D. 0.5% w/w B. 5.6% w/w Correct! 5 grams/90 grams x 100 = 5.6% w/w The PCA machine holds 50 mL, containing 500 micrograms of analgesic. A bolus dose of 0.025 mg is entered. Calculate the volume required. Select one: A. 1 mL B. 2 mL C. 2.5 mL D. 1.5 mL Not 2ml Question 17 Not yet answered Marked out of 1 Question text There is 200 micrograms of Drug A in 5 millilitres. How many mL are required if 1 milligram is prescribed? Select one: A. 0.025 mL B. 2.5 mL C. 25 mL D. 250 mL C. 25 mL Correct! 200 micrograms in 5 mL = 0.2 mg in 5 mL - Therefore: 1mg dose in 25 mL Remember: 1% w/w = 1g in 100g 1% v/v = 1 mL in 100 mL 1% w/v = 1 g in 100 mL 1% v/w = 1 mL per 100 g Question 18 Not yet answered Marked out of 1 Question text A medication is supplied as 100 micrograms/mL. The doctor has prescribed 0.2 mg IM, QID. What is the volume required for each dose? Select one: A. 8 mL B. 2 mL C. 1 mL D. 4 mL Not 4ml Question 19 Not yet answered Marked out of 1 Question text IV therapy is ordered for a patient. They are to have 2 litres of 0.9% saline over 12 hours. The set delivers 20 drops per mL, calculate the rate of infusion in drops per minute. Select one: A. 56 drops/min B. 3 drops/min C. 120 drops/min D. 10 drops/min A. 56 drops/min Correct! 2 L in 12 hours = 2000 mL in 12 hours 1666.667 mL in 60 min = 2.778 mL/min = 55.56 drop/min = approx. 56 Question 20 Not yet answered Marked out of 1 Question text Express 50 g of drug B in 500 mL of solution as a percentage: Select one: A. 10% v/v B. 100% w/v C. 10% w/v D. 1% w/v Not 10% Remember: 1% w/w = 1g in 100g 1% v/v = 1 mL in 100 mL 1% w/v = 1 g in 100 mL 1% v/w = 1 mL per 100 g Which of the following medications may require a medical officer to get approval from Department of health and aging?  Thalidomide  Danazol  Testosterone  Danaparoid Pharmacist regularly making dispensing error. What would you do?  Mandatory notification  Voluntary notification  Not doing anything A locum pharmacist looks intoxicated after having lunch. What would you do  Mandatory notification  Voluntary notification  Not doing anything A methadone patient lost his takeway on a Saturday and GP won’t be available until Monday.  Do not give him anything- refuse supply unless you get into contact w the doctor  Give him the dose for today  Give him takeaways doses and contact doctor on Monday What is correct for a non-streamlined authority Rx  A dentist can write authority prescription within the scope of dental practice  Non-streamlined authority prescription is not valid until approval from Department of health  Medical practitioner are allowed to write more than one authority item on a non-streamlined Rx Doctor called for patient info treated by another doctor  Do not give anything regardless of consent  Give health information if you deem is important to the patient health  Provide information after having a written consent  Provide information first and get the consent after Privacy and confidentiality Commonwealth, State and Territory privacy laws set out the privacy principles applicable to health providers. Pharmacists should ensure that all pharmacy services are provided in a manner that respects the patient’s privacy requirements, and is in accordance with relevant professional and quality assurance standards. Guidelines Information about a person that a pharmacist obtains in the course of professional practice is confidential and may be disclosed only: 1. with that person’s permission or 2. to other persons authorised to the extent of the latter person’s lawful jurisdiction or 3. on a court order or 4. if, in the pharmacist’s opinion, it is in the patient’s best interest to divulge pertinent information to another health practitioner who is treating the patient. Authorised persons include: a Pharmacy Board of Australia officer or an Australian Health Practitioner Regulation Agency (AHPRA)- appointed investigations officer an officer of the State or Territory pharmacy authority a person authorised under the State or Territory poisons law (including a member of the police force to the extent authorised) a member of an enforcement agency in accordance with the Privacy Act 1988 (Cwth), or State or Territory privacy laws an authorised officer of Medicare Australia for the purposes of examining prescriptions supplied as pharmaceutical benefits under the National Health Act 1953 (Cwth) an authorised officer of State or Territory statutory authorities that administer laws of work or road trafficrelated insurance. Particular care should be exercised if other official bodies seek information. State or Territory privacy authorities should be contacted in cases of uncertainty. The name or details of a therapeutic product (medicines and devices) should not be identified in information given to other than the person for whom it was intended, unless the person waives that right. Examples of persons to whom information may be inadvertently disclosed could include a person paying a family account or to third party organisations (including service companies) that process accounts, and organisations collecting statistical data. The inadvertent disclosure of the identities of patients’ medicines (and therefore the patients’ medical conditions) to third parties is to be avoided. How long is a S4 prescription valid for?  6 months  12 months  18 months  24 months Which of the following medications can a medical practitioner order free of charge from PBS so that he/she can supply to patient when emergency?  Oxycodone  Haloperidol  Insulin  Isosorbide mononitrate Which schedule; does, “Substances with a low potential for causing harm, the extent of which can be reduced through the use of appropriate packaging with simple warnings and safety directions on the label”, apply to? Schedule 5. Caution – Substances with a low potential for causing harm, the extent of which can be reduced through the use of appropriate packaging with simple warnings and safety directions on the label. Prochlorperazine approved S3 indication: (susmp)  in divided preparations for oral use in packs containing not more than 10 dosage units for the treatment of nausea associated with migraine Which of the following CAN NOT prescribe oral Codeine 30mg?  Optometrist cannot prescribe oral formulations of medications- only eye drops Which locations can use a PRF (prescription record file) for safety net?  Community pharmacies and approved hospitals What is the maximum number of PBS items ; authorised on a single prescription (excluding authority prescriptions)? Community Hospital scripts  Three items on one script  Max 10 items on one script  Authority items only ONE PER SCRIPT  Authorities can be mixed and written on  Cant have a mix of PBS and non PBS items the same script  Cant defer auth items  Pharmacist can defer auth items  Non PBS items don’t contribute to the SN  Non pbs items can count towards the threshold hospital formulary The functions of the Pharmacy Board of Australia include:  registering pharmacists and students  developing standards, codes and guidelines for the pharmacy profession  handling notifications, complaints, investigations and disciplinary hearings  assessing overseas trained practitioners who wish to practise in Australia  approving accreditation standards and accredited courses of study. Which of the following is requires a mandatory report to AHPRA?  PIC has a sexual relationship with a patient  PIC has a mental condition which is adequately controlled by medications  PIC has a medical condition which is adequately controlled by medications  PIC is intoxicated Mandatory notification Notifiable conduct by registered health practitioners is defined as:  practising while intoxicated by alcohol or drugs  sexual misconduct in the practice of the profession  placing the public at risk of substantial harm because of an impairment (health issue), or  placing the public at risk because of a significant departure from accepted professional standards. Which of the following medication is it most appropriate to put label 1  Mirtazapine  Duloxetine  Venlafaxine  Ondansetron  Allopurinol Pharmacy going give reward/incentive for the pharmacist who sells the most vitamins, what does this compromise?  Patient confidentiality  Pharmacist autonomy A pharmacist respects the autonomy and dignity of each patient. A pharmacistpromotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacistcommunicates with patients in terms that are understandable.  Business privacy Which of these is an inappropriate way of discarding private sensitive patient information  All the options had shredding an

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