Module 3 - FPB

B) 12 mg

prescription calls for the dispensing of a 4% pilocarpine HCl solution with the signa, "1 gtt o.u. tid". How many mg of the drug is being used per day if the dropper is calibrated to deliver 20 drops to the mL?
A. 0.012 mg
B. 12 mg
C. 0.3 mg
D. 80 mg

A) 10 drops/minute

A physician ordered an infusion of Normal Saline Solution (NSS) 500 mL to run over 5 hours using a 15 drops/mL IV set. After 1 1/2 hours, you find that only 150 mL remains in the bag. At what rate in drops per minute should you reset the infusion to complete it on time?
A. 10 drops/minute
B. 5 drops/minute
C. 25 drops/minute
D. 20 drops/minute

B) Type 2

What type of diabetes is previously known as non-insulin dependent diabetes?
A. Type 1
B. Type 2
C. Type 3
D. Type 4
E. Type 5

B) 274.15 K

Convert 1°C to K
A. 273.15 K
B. 274.15 K
C. 275.15 K
D. 276.15 K
E. 277.15 K

C) Topical

What is the most common route of administration for polymyxin B in treating infections?
A. Oral
B. Intramuscular
C. Topical
D. Rectal

A) Core list

Which category of the WHO Model List of Essential Medicines represents the minimum medicine requirements of a basic healthcare system and includes medicines selected for priority health conditions?
A. Core list
B. Complementary list
C. Alternative list
D. None of the above

A) Chronic kidney disease (CKD)

Epoetin is primarily used to treat anemia associated with which condition?
A. Chronic kidney disease (CKD)
B. Acute bacterial infections
C. Hypertension
D. Diabetes mellitus

D) Transcription

Part of the prescription: "Take 2 tablets twice a day for 7 days."
A. Superscription
B. Inscription
C. Subscription
D. Transcription
E. NOTA

D) Precipitant drug

Which drug causes the reaction in a drug interaction?
A. Dangerous drug
B. Herbal drug
C. Object drug
D. Precipitant drug
E. NOTA

A) Standard treatment guidelines

Set of evidence-based recommendations developed to guide healthcare providers in the diagnosis, treatment, and management of common medical conditions?
A. Standard treatment guidelines
B. Essential medicines list
C. Rational drug therapy
D. Drug utilization review

D) 16 mL

A patient needs 40 mEq of NaCl. How many mL should a pharmacist withdraw from the vial if the available preparation has a concentration of 2.5 mEq/mL?
A. 8 mL
B. 10 mL
C. 15 mL
D. 16 mL
E. 20 mL

B) Antitussive, Expectorant

TRUE about dextromethorphan and guaifenesin, respectively:
A. Expectorant, Antitussive
B. Antitussive, Expectorant
C. Both are Antitussive
D. Both are Expectorant

A) Right ear

A prescription reads: "Gentamicin sulfate, instill 2 drops AD tid for 7 days". What does AD mean in this prescription?
A. Right ear
B. Left ear
C. Right eyes
D. Both ears
E. Both eyes

A) Sulfamethoxazole + Trimethoprim

Which of the following drug combinations is the first-line treatment used for Pneumocystis pneumonia (PCP)?
A. Sulfamethoxazole + Trimethoprim
B. Sulfadoxine + Pyrimethamine
C. Sulfadiazine + Trimethoprim
D. Amoxicillin + Clavulanic acid

B) Increase in effect of Drug B

Drug A has a higher binding affinity to plasma proteins than Drug B. Which of the following statements is/are TRUE?
A. Increase in effect of Drug A
B. Increase in effect of Drug B
C. Decrease in effect of Drug A
D. Decrease in effect of Drug B
E. No change in effects

C) Reduced drug activation

A genetically slow metabolizer is prescribed a prodrug. What is the most likely clinical outcome?
A. Enhanced therapeutic effect
B. Rapid drug clearance
C. Reduced drug activation
D. Decreased risk of side effects

B) Category G

A pregnant woman decided to take Doxycycline after she treaded in floody waters. Her child developed permanent yellow-gray-brown discoloration of the teeth and enamel hyperplasia. What medication error category occurred?
A. Category D
B. Category G
C. Category F
D. Category H

C) All of the above

Which of the following is an example of irrational medicine use?
A. anabolic steroids for growth/appetite stimulation
B. Use of antibiotics for treatment of URTI in minors
C. All of the above
D. None of the above

C) Potentiation

A patient has been prescribed Amoxicillin + clavulanic acid. What interaction exists between Amoxicillin and clavulanic acid?
A. Addition
B. Synergism
C. Potentiation
D. Antagonism
E. NOTA

B) Decreased effect of OCP

A patient was prescribed oral contraceptive pills (OCP) while taking antibiotics for an infection. What drug interaction can possibly occur?
A. Increased effect of OCP
B. Decreased effect of OCP
C. Increased metabolism of OCP
D. Decreased metabolism of OCP
E. NOTA

C) History of myocardial infarction

A 54-year-old woman presented with signs and symptoms consistent with an early stage of rheumatoid arthritis. The decision was made to initiate NSAID therapy.Which of the following patient characteristics is the most compelling reason for avoiding celecoxib in the treatment of her arthritis?
A. History of alcohol abuse
B. History of gout
C. History of myocardial infarction
D. History of peptic ulcer disease

D) Randomized Controlled Trial

Study design used to test the efficacy of a drug or a study intervention
A. Case-Control
B. Cohort
C. Cross-Sectional
D. Randomized Controlled Trial
E. NOTA

A) Type A

Beta blocker overdose may lead to bradycardia. This type of adverse drug reaction can be classified as:
A. Type A
B. Type B
C. Type C
D. Type D

C) 904

CMIV
A. 1004
B. 1106
C. 904
D. 504

B) MAO inhibitors

A patient was rushed to the emergency room and was found to have hypertensive crisis. Prior to the ER visit, he was dining in a restaurant, eating lots of cheese and wine. Which of the following drugs was the patient most likely taking?
A. COMT inhibitors
B. MAO inhibitors
C. ACE inhibitors
D. Angiotensin receptor blockers
E. Alpha-1 blockers

B) Ondansetron

The following act as histamine receptor agonists, EXCEPT:
A. Sumatriptan
B. Ondansetron
C. Ergotamine
D. Cisapride

C) 57.90 mL

Syrup is an 85% w/v solution of sucrose in water. It has a density of 1.313 g/mL. How many milliliters of water should be used to make 125 mL of syrup?
A. 106.25 mL
B. 164.10 mL
C. 57.90 mL
D. 25.00 mL

E) AOTA

Which of the following drug/s require therapeutic drug monitoring?
A. Warfarin
B. Heparin
C. Digoxin
D. Lithium
E. AOTA

C) Increased metabolism leading to reduced drug levels

Enzyme inducers generally cause which of the following effects on drugs metabolized by the same enzyme?
A. Increased plasma drug levels and toxicity
B. Decreased metabolism leading to accumulation
C. Increased metabolism leading to reduced drug levels
D. No change in drug concentration or effect

B) Pull system

What drug distribution system is used wherein peripheral facilities determine the number of items to be supplied from the warehouse?
A. Push system
B. Pull system
C. Direct procurement
D. Just-in-time system
E. NOTA

C) III only

For items 31-34, refer to the following choices:
I. Pharmacy Aides
II. Pharmacy Assistants
III. Pharmacy Technicians
IV. Pharmacists
Refer to persons who assist in compounding and dispensing of medicines in community, hospital, institutional and industrial settings or engaged in other activities under the supervision of the pharmacist
A. I only
B. II only
C. III only
D. IV only
E. I and II

E) I and II

Refer to persons who assist the pharmacists in the different aspects of pharmacy operation based on established standard operating procedures and processes
A. I only
B. II only
C. III only
D. IV only
E. I and II

B) II only

with a minimum degree of independence or decision making and may have supervised interaction with patients
A. I only
B. II only
C. III only
D. IV only
E. I and II

A) I only

with very minimal degree of independence or decision making and without direct interaction with patients
A. I only
B. II only
C. III only
D. IV only
E. I and II

D) 10 g = 1 hg

All of the following conversions are true EXCEPT
A. 10 g = 1 dag
B. 1000 g = 1 kg
C. 1 g = 1000 mg
D. 10 g = 1 hg

D) 2.5%

If 500 mL of a 1:20 (w/v) solution was diluted to 1,000 mL, what will be the percentage strength?
A. 1.0%
B. 1.5%
C. 2.0%
D. 2.5%
E. 3.0%

A) Increased effect of warfarin

A patient was prescribed warfarin while taking antibiotics for an infection. What drug interaction can possibly occur?
A. Increased effect of warfarin
B. Decreased effect of warfarin
C. Increased metabolism of warfarin
D. Decreased metabolism of warfarin
E. NOTA

C) Liver

Increases in ALT and AST values typically indicate damage in which of the following organ/s?
A. Heart
B. Kidneys
C. Liver
D. Pancreas
E. NOTA

B) Omeprazole beads in applesauce for patient with trouble swallowing capsules secondary to GERD

Which of the following is NOT a harmful/unwanted food-drug interaction?
A. Green leafy vegetables for patients on warfarin therapy as deep vein thrombosis prophylaxis
B. Omeprazole beads in applesauce for patient with trouble swallowing capsules secondary to GERD
C. Grapefruit juice and cyclosporine to prevent organ transplant rejection
D. Antiosteoporosis drug, alendronate, taken with food to minimize GI irritation

A) Tetracyclines

Antacids should not be given within 2 hours with which of the following drugs?
A. Tetracyclines
B. Paracetamol
C. Loratadine
D. Metoprolol
E. NOTA

C) Phenoxymethylpenicillin

Which of the following antibiotics can be given by mouth?
A. Benzylpenicillin
B. Ticarcillin
C. Phenoxymethylpenicillin
D. Piperacillin

B) Haemolysis of the blood sample

Which preanalytical factor is a common cause of a falsely elevated serum potassium result (pseudohyperkalaemia)?
A. Recent consumption of leafy vegetables
B. Haemolysis of the blood sample
C. Consumption of a high-fat meal
D. Lack of sleep before blood collection

A) 1 tsp

A patient weighing 185 lbs is prescribed with a dose of 3 mg/kg/dose QID. If the only available formulation for the prescribed drug has a concentration of 250 mg/5 mL, how many teaspoons are needed per dose?
A. 1 tsp
B. 2 tsp
C. 3 tsp
D. 4 tsp
E. 5 tsp

B) Relief of nasal and sinus congestion

Which of the following is the primary indication for the use of pseudoephedrine?
A. Treatment of bacterial sinus infections
B. Relief of nasal and sinus congestion
C. Long-term management of hypertension
D. Reduction of chronic cough due to bronchitis

C) No significant impact is expected

A patient uses topical lidocaine 5% patches for localized back pain. They begin a new medication that inhibits CYP3A4. Which of the following is the most likely outcome?
A. Systemic lidocaine toxicity is expected
B. Increased sedation from lidocaine
C. No significant impact is expected
D. Complete loss of analgesic effect

C) enzyme induction by St. John's wort causing increased metabolism of ART.

A patient on indinavir antiretroviral therapy (ART) begins taking St. John's wort for depression and suffers unexpected reduction in CD4 count. This is most likely due to:
A. pharmacodynamic interaction producing additive toxicity.
B. pharmacodynamic interaction producing antagonistic therapeutic effect.
C. enzyme induction by St. John's wort causing increased metabolism of ART.
D. enzyme inhibition by St. John's wort causing toxic levels of ART.

A) increase in the absorption of griseofulvin

Taking griseofulvin with high fatty meal will most likely result to __________.
A. increase in the absorption of griseofulvin
B. decrease the elimination of griseofulvin
C. potentiates the side effects of griseofulvin
D. decrease in the absorption of Griseofulvin

D) Pharmacologically inactive

Drugs bound to plasma proteins are:
A. Free drugs
B. Readily excretable
C. Pharmacologically active
D. Pharmacologically inactive

B) Antitussive

What is the classification of Dextromethorphan?
A. Mucolytic
B. Antitussive
C. Expectorant
D. Mucokinetics

D) Imipenem

A patient was found to be allergic to penicillin. Which of the following drugs must be avoided in this patient as it can cause cross-sensitivity?
A. Streptomycin
B. Clindamycin
C. Azithromycin
D. Imipenem
E. Doxycycline

B) Chlorhexidine

Which of the following substances is commonly used as a topical antiseptic to clean the skin?
A. Gentian violet
B. Chlorhexidine
C. Benzalkonium chloride
D. Basic fuschin

C) No significant interaction occurs

When ketoconazole cream, a CYP450 inhibitor, is combined with warfarin, what is the expected effect?
A. Decreased anticoagulant effect of warfarin
B. No significant interaction occurs
C. Increased anticoagulant effect of warfarin
D. Increased metabolism of warfarin

C) Immediately, without delay

A "STAT" order means that the drug should be administered:
A. Within 24 hours
B. As soon as possible, but not immediately
C. Immediately, without delay
D. At the next scheduled time

C) Subcutaneously

Insulin preparations are typically administered through what route?
A. Orally
B. Intravenously
C. Subcutaneously
D. Intradermal
E. NOTA

B) 24 hours

What is the usual expiration dating that should be placed on a parenteral admixture prepared in a hospital pharmacy?
A. 1 hour
B. 24 hours
C. 48 hours
D. 72 hours

B) Document the herbal products, assess for additive glucose-lowering effects, and advise glucose monitoring

A patient with diabetes reports taking metformin, insulin, ampalaya capsules, and banaba tea. What is your most appropriate role as the pharmacist?
A. Recommend stopping all herbal products immediately
B. Document the herbal products, assess for additive glucose-lowering effects, and advise glucose monitoring
C. Reassure the patient that herbal products cannot interact with medicines
D. Advise taking the herbal products separately from insulin

A) Dehydration

An elevated haematocrit level is most commonly associated with which condition?
A. Dehydration
B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
C. Anaemia
D. All of the above

A) Methyldopa

Which of the following drugs can cause a false positive result in the Coombs Test?
A. Methyldopa
B. Clonidine
C. Hydralazine
D. Labetalol
E. Nifedipine

C) It acts as an anti-muscarinic agent

Which of the following statements about meclizine is NOT true?
A. It is used to prevent motion sickness
B. It is available in chewable form
C. It acts as an anti-muscarinic agent
D. It helps manage Meniere's disease

B) II, III

Which antipsychotic drug belongs to the class of phenothiazines?
I. Thiothixene
II. Thioridazine
III. Fluphenazine
IV. Haloperidol
A. I, IV
B. II, III
C. I, III, III
D. I, II, III, IV

B) Category B

A pharmacist identifies that the wrong medicine was prepared during dispensing. The error is corrected before the medicine reaches the patient. Under the NCC MERP classification, what is the category of this medication error?
A. Category A
B. Category B
C. Category C
D. Category D

D) Headache

A patient is prescribed isosorbide dinitrate for angina. What is the most common side effect associated with ISDN therapy?
A. Constipation
B. Bradycardia
C. Rash
D. Headache

C) Omission error

For questions 63-64 refer to the case below.
A patient was supposed to receive digoxin 0.25 mg orally in the morning but did not receive the dose. The patient's nurse was so busy that he/she forgot to administer the dose. The patient was then closely monitored. What is the type of error?
A. Wrong time error
B. Wrong dose error
C. Omission error
D. Prescribing error
E. Extra dose error

C) Category D

What is the category of the above medication error according to NCC-MERP?
A. Category B
B. Category C
C. Category D
D. Category E
E. Category F

E) S

Treating tuberculosis requires combination therapy. Among the following drugs for tuberculosis, which can cause ototoxicity?
A. H
B. R
C. Z
D. E
E. S

A) Proprietary Name

Which of the following is another term for brand name?
A. Proprietary Name
B. Non-Proprietary Name
C. Generic Name
D. Chemical Name
E. NOTA

D) Type F reaction

Failure of an oral contraceptive due to an interaction with an enzyme-inducing medicine is an example of:
A. Type B reaction
B. Type C reaction
C. Type E reaction
D. Type F reaction

A) Elevated serum uric acid level

A patient was prescribed febuxostat and showed you her laboratory results. Which of the following laboratory findings is the most likely reason for prescribing febuxostat?
A. Elevated serum uric acid level
B. Increased triglyceride
C. Low HDL
D. Elevated liver enzymes

C) Propranolol

Which of the following beta-blockers should not be prescribed in a patient with bronchial asthma?
A. Atenolol
B. Metoprolol
C. Propranolol
D. Bisoprolol
E. Nebivolol

C) I, II, and III only

Which of the following statements regarding parenteral nutrition (PN) are correct?
I. PN is a sterile, physicochemically stable solution or emulsion administered intravenously.
II. Total parenteral nutrition may provide carbohydrates, amino acids, lipid emulsions, electrolytes, vitamins, and trace elements.
III. PN is indicated when the gastrointestinal tract is inaccessible or nonfunctional, or when oral or enteral nutrition cannot adequately meet nutritional requirements.
IV. PN should always be withheld until inadequate oral intake has continued for 7–14 days.
A. I and II only
B. II and III only
C. I, II, and III only
D. I, II, III, and IV

A) 1 + 0 = 2

A patient is taking Probenecid which when co-administered with Penicillin significantly increases the antibiotic's plasma levels by reducing its excretion. This interaction is best represented by which equation?
A. 1 + 0 = 2
B. 1 + 1 = 0
C. 1 + 1 > 2
D. 1 + 1 = 2

B) Assess and stabilise the patient while withholding the suspected medicine

A patient develops a suspected serious adverse drug reaction shortly after receiving a medication. What should the pharmacist recommend as the initial action?
A. Discontinue the suspected medicine and submit an ADR report immediately
B. Assess and stabilise the patient while withholding the suspected medicine
C. Review the patient's medication history and assess the reaction's causality
D. Document the reaction and notify the prescribing physician

E) Autonomy

You are counseling the grandmother of a 3-year-old boy who has a prescription for amoxicillin/clavulanate (Augmentin) to treat uncomplicated otitis media. Which of the following issues would be least likely to affect medication adherence (compliance)?
A. Lack of education about the medication
B. Cost
C. Dosing interval (frequency)
D. Taste
E. Autonomy

C) Morphine

Which medicine requires secure controlled-drug storage, restricted access, detailed transaction records, and regular inventory reconciliation?
A. Warfarin
B. Digoxin
C. Morphine
D. Insulin

A) CD4+ T cells

Which of the following cells does HIV destroy?
A. CD4+ T cells
B. CD8 T cells
C. Red blood cells
D. Platelets
E. NOTA

C) Two medicines produce an excessive pharmacological effect when used together

Which is the best example of a therapeutic incompatibility?
A. A precipitate forms in a liquid preparation
B. Two powders liquefy when combined
C. Two medicines produce an excessive pharmacological effect when used together
D. A drug undergoes oxidation during storage

B) Type B reaction

Anaphylaxis following administration of penicillin is classified as a:
A. Type A reaction
B. Type B reaction
C. Type C reaction
D. Type E reaction

A) 7

A pharmacist has 5 gallons of 70% alcohol. Calculate the proof gallons.
A. 7
B. 8
C. 9
D. 10
E. 11

B) Diabetes mellitus

Banaba (Lagerstroemia speciosa) is traditionally used primarily as an adjunct for which condition?
A. Asthma
B. Diabetes mellitus
C. Urinary tract infection
D. Hyperuricemia

A) Sulfisoxazole

Which of the following may cause drug-induced kernicterus in neonates?
A. Sulfisoxazole
B. Amoxicillin
C. Gentamicin
D. Penicillin

A) To keep commonly required medicines readily available in patient-care areas

What is the primary purpose of a floor-stock system?
A. To keep commonly required medicines readily available in patient-care areas
B. To allow patients to select their own medicines
C. To eliminate inventory control
D. To store only expired medicines

D) It reflects the information that is given by the patient in his or her own words.

The "S" section of SOAP notes should contain which of the following?
A. It contains laboratory results, vital signs, and physical findings found during the patient examination.
B. It includes a summary of the interviewer's plan to treat the patient.
C. It includes prescription and referral
D. It reflects the information that is given by the patient in his or her own words.

B) I, II, III

Which of the following macronutrients are found in Total Parenteral Nutrition?
I. Carbohydrates
II. Proteins
III. Fats
IV. Vitamins
A. I, II, III, IV
B. I, II, III
C. I, II, IV
D. I, III, IV

B) A continually updated list of medicines approved for use in the hospital

The hospital formulary is best described as:
A. A list of all medicines manufactured worldwide
B. A continually updated list of medicines approved for use in the hospital
C. A list of medicines owned by individual patients
D. A record containing only controlled medicines

B) Phase I

Which phase of clinical trials makes use of healthy volunteers to assess the safety and dosing of the drug?
A. Pre-clinical trials
B. Phase I
C. Phase II
D. Phase III
E. Phase IV

A) Substance/Drug Abuse Treatment and Rehabilitation Center

According to the New Classification of "Other Health Facilities" under AO 2012-0012, the following are examples of Category D Health Facility, EXCEPT:
A. Substance/Drug Abuse Treatment and Rehabilitation Center
B. Dialysis Clinic
C. Physical Medicine and Rehabilitation Center/Clinic
D. In-Vitro Fertilization Center

C) 8 drops

How many drops should would be prescribed in each dose of a liquid medicine if 15 mL contained 60 doses? The dispensing dropper calibrates 32 drops/mL.
A. 9 drops
B. 7 drops
C. 8 drops
D. 10 drops

B) Suspected

Drug interaction that may occur supported with some good data but needs more study
A. Probable
B. Suspected
C. Possible
D. Established

C) Phase III

The new drug or treatment is given to large groups of people (1,000–3,000) to confirm its effectiveness, monitor side effects, compare it with standard or similar treatments, and collect information that will allow the new drug or treatment to be used safely. This is under what phase of clinical trial?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV

B) I, II

When dispensing Metronidazole, patients must be advised with the following:
I. Avoid alcoholic beverages consumption
II. Discoloration of urine while using the drug
III. Take only on an empty stomach
A. I only
B. I, II
C. I, II, III
D. I, III

C) shorter duration of pharmacologic response

Decreased urinary recycling results to increased elimination rate hence:
A. increases drug's half-life
B. longer duration of pharmacologic response
C. shorter duration of pharmacologic response
D. decrease in drug clearance

B) 26 gtt/min

15 mL of 10% Calcium Gluconate injection and 10 mL of a multivitamin infusion are mixed with 500 mL of NSS. The infusion is to be administered over a period of 5 hours. If the infusion set is calibrated at 15 drops per mL, at what rate in drops per minute should the flow rate be adjusted in order to administer the infusion over the desired time interval?
A. 25 gtt/min
B. 26 gtt/min
C. 0.12 gtt/min
D. 7 gtt/min

A) Activated partial thromboplastin time

A patient on heparin therapy may be monitored with?
A. Activated partial thromboplastin time
B. Prothrombin time
C. Complete blood count
D. International normalized ratio

C) IV only

Which of the following is an anticoagulant?
I. Aspirin
II. Clopidogrel
III. Cilostazol
IV. Warfarin
A. I, IV
B. I, II, IV
C. IV only
D. All of the above

B) Anti-emetic

Granisetron
A. Anti-inflammatory
B. Anti-emetic
C. Anticoagulant
D. Antithrombotic

C) 10%

What is the percentage of zinc oxide in an ointment prepared by mixing 200g of 10% ointment, 50g of 20% ointment and 100g of 5% ointment?
A. 1.0%
B. 100%
C. 10%
D. NOTA

D) Progressive increase in glucose

Effect of high dose dexamethasone
A. Sudden decrease in glucose
B. Gradual decrease in glucose
C. Cyclic decrease in glucose
D. Progressive increase in glucose

C) Receiving incoming supply

Which of the following factors will increase the "stock-on-hand" of a drug?
A. Dispensing the drug to patient
B. Returning of drug to the supplier
C. Receiving incoming supply
D. AOTA

A) Precipitant drug

The substance that causes the interaction when combined with other drugs, chemicals or food
A. Precipitant drug
B. Object drug
C. Lead drug
D. Subject drug

D) Can be used without monitoring the patient's aPTT

The decision was made to treat this woman with enoxaparin (a LMWH). Relative to unfractionated heparin, enoxaparin
A. Is more likely to cause thrombosis and thrombocytopenia
B. Is more likely to be given intravenously
C. Is less likely to have a teratogenic effect
D. Can be used without monitoring the patient's aPTT