M3: Clinical Pharmacy - General Concepts

A health science discipline in which pharmacist provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention. (American College of Clinical Pharmacy)

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

a. Clinical Pharmacy

It includes broad responsibility for safe and appropriate use of drugs specifically

• Rational selection

• Monitoring

• Dosing

• Control of the patients' overall drug therapy program

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

a. Clinical Pharmacy

Is a cooperative, patient-centered system for achieving specific and positive patient outcomes from the responsible provision of medicines. (Hepler and Strand, 1990)

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

b. Pharmaceutical Care

Responsible provision of drug therapy for the purpose of achieving definite outcomes to improve the patients quality of life.

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

b. Pharmaceutical Care

Included in pharmaceutical care plan except:

a. Assessment

b. Plan

c. Monitoring

d. Documentation

e. None

e. None

Aims to ensure that the right patients get the right choice of medicine at the right time.

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

c. Medicines optimization

The purpose is to help patients take their medicines appropriately and, by doing so, avoid unnecessary treatment, improve safety and outcomes, and reduce wastage. (Royal Pharmaceutical Society, 2013)

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

c. Medicines optimization

Characteristics of Clinical Pharmacy except:

a. Not product oriented but patient oriented

b. Primary objective is rational drug use

c. Practice in both community and hospital setting

d. Multidisciplinary

e. None

e. None

Requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and at the lowest cost to them and their community. (WHO, 1985)

a. Clinical Pharmacy

b. Pharmaceutical Care

c. Medicines optimization

d. Rational Drug Use

d. Rational Drug Use

OTC drugs that can be severely habit forming except:

a. Decongestants

b. Laxatives and Antacids

c. Antihistamines

d. Sleep aids

e. Ephedrine

f. None

f. None

Clinical pharmacy setting include all of the following except:

a. Hospitals

b. Community pharmacies

c. Nursing homes

d. Home-based care services

e. Clinics and any other setting where medicines are prescribed and used

f. None

f. None

Pharmaceutical Care Process include:

a. Assessment

b. Care Plan

c. Evaluation of outcome

d. a and b

e. All

e. All

Outcome of pharmaceutical care except:

a. Minimizing or eliminating patient's symptoms

b. Modifying or curing of disease process

c. Improve the prognosis of patients

d. Identifying and resolving drug related problems

e. Preventing drug misadventures

f. None

f. None

Drug misadventure is aka:

a. Adverse drug event

b. Medication error

c. Adverse drug reaction

d. Toxicity

a. Adverse drug event

Cause by preventable reasons.

a. Adverse drug event

b. Medication error

c. Adverse drug reaction

d. Toxicity

b. Medication error

Mainly because of overdose.

a. Adverse drug event

b. Medication error

c. Adverse drug reaction

d. Toxicity

d. Toxicity

Practice of pharmacy that responds to the needs of people who use pharmacists' services i order to provide optimal evidenced based care.

a. Good Clinical Practice

b. Good Pharmacy Practice

c. Good Dispensing Practice

b. Good Pharmacy Practice

Written summary of all the medicines taken regularly, including over-the-counter and complementary medicines.

a. Patient Medication Profile (PMF)

b. Medication Reconciliation Process

c. Patient Medical Chart (PMC)

a. Patient Medication Profile (PMF)

Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking including drug name, dosage, frequency, and route and comparing that list against the physician's orders, with the goal of providing correct medications.

a. Patient Medication Profile (PMF)

b. Medication Reconciliation Process

c. Patient Medical Chart (PMC)

b. Medication Reconciliation Process

Contains all significant clinical information which enables the physician to give effective continuing care to the patient. It is used as basis for drug therapy plan for patient.

a. Patient Medication Profile (PMF)

b. Medication Reconciliation Process

c. Patient Medical Chart (PMC)

c. Patient Medical Chart (PMC)

Normal body temperature:

a. 37 ± 0.2 °C

b. 37 ± 0.5 °C

c. 36 ± 0.2 °C

d. 36 ± 0.5 °C

b. 37 ± 0.5 °C

Most accurate route for determining temperature:

a. Oral

b. Rectal

c. Axillary

d. Tympanic

b. Rectal

Normal pulse rate (beats/minute):

a. 50-70

b. 60-80

c. 70-100

d. 60-100

d. 60-100

Normal respiratory rate:

a. 10-15 breaths/minute

b. 10-18 breaths/minute

c. 16-20 breaths/minute

d. 16-25 breaths/minute

c. 16-20 breaths/minute

No breathing:

a. Apnea

b. Bradycardia

c. Tachnea

a. Apnea

Normal blood pressure:

a. 130/90

b. 100/90

c. 110/90

d. 120/80

d. 120/80

Selection tools is hospital pharmacy that is drug-centered and include precaution, warning, and contraindications.

a. Formulary list

b. Formulary manual

c. Standard treatment guideline

b. Formulary manual

Selection tools is hospital pharmacy that is disease-centered and more on prescribing.

a. Formulary list

b. Formulary manual

c. Standard treatment guideline

c. Standard treatment guideline

Vinca toxicity.

a. Neurotoxicity

b. Epistaxis

c. Cardiotoxicity

d. Pulmonary fibrosis

a. Neurotoxicity

Plicamycin toxicity.

a. Neurotoxicity

b. Epistaxis

c. Cardiotoxicity

d. Pulmonary fibrosis

b. Epistaxis

Daunorubicin toxicity.

a. Neurotoxicity

b. Epistaxis

c. Cardiotoxicity

d. Pulmonary fibrosis

c. Cardiotoxicity

Irinotecan, bleomycin and busulfan toxicity.

a. Neurotoxicity

b. Epistaxis

c. Cardiotoxicity

d. Pulmonary fibrosis

d. Pulmonary fibrosis

Methotrexate toxicity.

a. Pulmonary fibrosis

b. Hepatotoxicity

c. Nephrotoxicity

d. Hemorrhagic cystitis

b. Hepatotoxicity

Cisplatin toxicity.

a. Pulmonary fibrosis

b. Hepatotoxicity

c. Nephrotoxicity

d. Hemorrhagic cystitis

c. Nephrotoxicity

Cyclophosphamide toxicity.

a. Pulmonary fibrosis

b. Hepatotoxicity

c. Nephrotoxicity

d. Hemorrhagic cystitis

d. Hemorrhagic cystitis

Treatment for daunorubicin toxicity.

a. Dexrazoxane

b. Leucovorin/Folinic acid

c. Amifostine

d. Mesna

a. Dexrazoxane

Treatment for methotrexate toxicity.

a. Dexrazoxane

b. Leucovorin/Folinic acid

c. Amifostine

d. Mesna

b. Leucovorin/Folinic acid

Treatment for cyclophosphamide toxicity.

a. Dexrazoxane

b. Leucovorin/Folinic acid

c. Amifostine

d. Mesna

d. Mesna

Treatment for Cisplatin toxicity.

a. Dexrazoxane

b. Leucovorin/Folinic acid

c. Amifostine

d. Mesna

c. Amifostine

Narrow therapeutic drug to which therapeutic drug monitoring should be done include the following except:

a. Anticonvulsant

b. Heparin, Warfarin

c. Lithium

d. Digoxin

e. Theophylline

f. None

f. None

Causes coarse tremors.

a. Lithium toxicity

b. Beta agonist toxicity

c. Sodium toxicity

d. Beta blocker toxicity

a. Lithium toxicity

Causes fine tremors.

a. Lithium toxicity

b. Beta agonist toxicity

c. Sodium toxicity

d. Beta blocker toxicity

b. Beta agonist toxicity - usually drugs for asthma.

Treatment guidelines for asthma.

a. GOLD

b. GINA

c. JNC

d. AHA

b. GINA

Treatment guidelines for COPD.

a. GOLD

b. GINA

c. JNC

d. AHA

a. GOLD

Treatment guidelines for hypertension.

a. JNC

b. ACC

c. AHA

d. a and b

e. b and c

f. All

f. All

ACC: normotensive

AHA: normotensive

a. <120/<80

b. 120-129/<80

c. 130-139/80-99

d. 140-159/90-99

e. NLT160/NLT100

f. NLT180/NLT120

a. <120/<80

ACC: Prehypertension

AHA: Elevated blood pressure

a. <120/<80

b. 120-129/<80

c. 130-139/80-99

d. 140-159/90-99

e. NLT160/NLT100

f. NLT180/NLT120

b. 120-129/<80

ACC: Hypertensive crisis

AHA: Hypertensive crisi

a. <120/<80

b. 120-129/<80

c. 130-139/80-99

d. 140-159/90-99

e. NLT160/NLT100

f. NLT180/NLT120

f. NLT180/NLT120

JNC 1st line agent for hypertension:

a. Ca Channel Blocker

b. ACEIs and ARBs

c. Thiazide diuretics

d. a and b

e. b and c

f. All

f. All

New York Heart Association (NYHA) heart failure class I:

a. Has no limitation to normal activity, symptoms appears when there is greater than normal activity

b. Slight limitation, symptoms at normal activity

c. Marked limitation, symptoms at greater than normal activity

d. Severe limitation, symptoms at rest

a. Has no limitation to normal activity, symptoms appears when there is greater than normal activity

New York Heart Association (NYHA) heart failure class II:

a. Has no limitation to normal activity, symptoms appears when there is greater than normal activity

b. Slight limitation, symptoms at normal activity

c. Marked limitation, symptoms at lesser than normal activity

d. Severe limitation, symptoms at rest

b. Slight limitation, symptoms at normal activity

New York Heart Association (NYHA) heart failure class III:

a. Has no limitation to normal activity, symptoms appears when there is greater than normal activity

b. Slight limitation, symptoms at normal activity

c. Marked limitation, symptoms at lesser than normal activity

d. Severe limitation, symptoms at rest

c. Marked limitation, symptoms at lesser than normal activity

New York Heart Association (NYHA) heart failure class IV:

a. Has no limitation to normal activity, symptoms appears when there is greater than normal activity

b. Slight limitation, symptoms at normal activity

c. Marked limitation, symptoms at lesser than normal activity

d. Severe limitation, symptoms at rest

d. Severe limitation, symptoms at rest

Unexpected occurrence involving death or serious physical and psychological injury or risk.

a. ADR

b. Bizarre ADR

c. Sentinel event

d. Error

c. Sentinel event

Measurement, comparison of inputs (cost of illness, cost of therapy) with outcomes (economic, clinical, humanistic) to select best option.

a. Pharmacoeconomics

b. Pharmacoanalysis

c. Pharmacodynamics

a. Pharmacoeconomics

Cost for drugs, investigations, physician visits, hospitalizations.

a. Direct medical cost

b. Direct non medical cost

c. Indirect cost

d. Intangible cost

a. Direct medical cost

Cost for transportation, food and lodging.

a. Direct medical cost

b. Direct non medical cost

c. Indirect cost

d. Intangible cost

b. Direct non medical cost

Include opportunity cost which is the lost potential gain from choosing alternative.

a. Direct medical cost

b. Direct non medical cost

c. Indirect cost

d. Intangible cost

c. Indirect cost

Suffering, pain, anxiety, inconvenience and grief during the treatment.

a. Direct medical cost

b. Direct non medical cost

c. Indirect cost

d. Intangible cost

d. Intangible cost

Determine least costly alternative when comparing treatment alternatives with same/ equal outcome.

a. Cost minimization analysis

b. Cost effectiveness analysis

c. Cost utility analysis

d. Cost benefit analysis

a. Cost minimization analysis

The outcome is clinical and the best choice is the most health effect than cost.

a. Cost minimization analysis

b. Cost effectiveness analysis

c. Cost utility analysis

d. Cost benefit analysis

b. Cost effectiveness analysis

Integrate patient performance and health related quality of life. Measures consequences in terms of quality adjusted life year (QALY) gained which is humanistic outcome.

a. Cost minimization analysis

b. Cost effectiveness analysis

c. Cost utility analysis

d. Cost benefit analysis

c. Cost utility analysis

Identify, measure and compare benefits and costs of a program regarding treatment alternative, where both costs and consequences are measured in monetary terms.

a. Cost minimization analysis

b. Cost effectiveness analysis

c. Cost utility analysis

d. Cost benefit analysis

d. Cost benefit analysis

Provide most current information. Include journals.

a. Primary source

b. Secondary source

c. Tertiary source

a. Primary source

For quick and selective screening of primary literature such as abstracting and indexing sources.

a. Primary source

b. Secondary source

c. Tertiary source

b. Secondary source

Provide easy and convenient access butinformation may be outdated. Include textbooks.

a. Primary source

b. Secondary source

c. Tertiary source

c. Tertiary source