CPJE 2024

Levothyroxine PO to IV

50% - 75% of the original dose

Monopril

Fosinopril

A home health pharmacy stocks medical oxygen, who regulates?

Joint Commission

DEA 222 forms

original to pharmacy, green copy (copy 2) to DEA, blue copy

(copy 3) to waste management company

Atropine incompatible with

dextrose solutions

Filling of controlled substances

Rph only

Clerk cannot

take drugs off shelf

Controlled substance inventory is every

2 years

Form 106

employee theft

Form 41

disposal of controls

Form 224

new application for pharmacy

Pharmacy technicians non-discretionary tasks...

1. remove drugs from stock

2. count/pour/mix

3. place product in container

4. affix label

5. package and repackage

Pharmacist shall notify board within ____ days of address/name change

30 days

How many days do you have to report an employee CS loss to the board?

14 days

How many days does a pharmacist have to join the boards email address?

60 days

Signing for an order by an intern is _____ permitted

not

Major CYP inducers

PS CROPS

1. Phenytoin

2. Smoking

3. Carbamazepine

4. Rifampin

5. Oxcarbazepine

6. Phenobarbital

7. St. Johns wort

Major CYP inhibitors

G <3 PACMAN

1. Grapefruit

2. P.I.s

3. Azoles.

4. Cimetidine

5. Macrolides

6. Amiodarone

7. Non-DHP CCBs

Acute UTI treatment

Bactrim, Nitrofurantoin, fosfomycin

MRSA treatment

Vanco

Dapto

Linezolid (Zyvox)

Nuzyra (omadacycline)

Tygacil

Telavancin

PO: bactrim, doxycycline, linezolid

Macrobid CrCl cut-off

<60 = DONT GIVE

chlamydia & gonorrhea treatment

ceftriaxone 500mg x 1, then doxy 100mg PO BID x 7d

Pseudomonal infection treatment

cipro + gentamycin

zosyn

ceftazidime (Fortaz)

Post surgical abdominal infections

Ertapenem

Zosyn

Levo/cipro + metronidazole

Chlamydia treatment

Azithro 1g PO x 1

Doxy 100mg PO BID x 7 d

Urine infection bugs

PEKEPS

Proteus, eccoli, klebsiella, enterococci, psuedomonas, staph saphro.

pyelonephritis

bactrim, urinary quinolones (cipro/levo)

IV ceftriaxone if pregnant

CAP treatment

amoxicillin 1g PO TID

doxy 100mg PO BID

if comorbidities: levo, moxi, gemifloxacin or PO beta-lactam (augmentin) + doxy or macrolide

Ribavirin

Preg cat X

Hemolytic anemia, monitor CBC

Monurol

Fosfomycin

simple UTI ONLY

Azactam

Aztreonam

Invanz

ertapenem

VRE treatment

Dapto

Synercid (quinapristin, dalfopristin)

Linezolid

Tigecycline

Oritavancin

Rifampin w/ or w/o food

empty stomach

RIFAMPIN IS ONE OF THE STRONGEST CYP INDUCERS

will decrease drug levels

PIs

LAND FIRST

-navir

Reyataz

Atazanavir (PI), w/ cobicistat (Evotaz)

Monitor ECG, AV blockage, CKD (nephrolithiasis, cholesthiasis)

Prezista

Darunavir (PI), w/ cobicistat (Prezcobix), w/ cobicistat + emtricitabine + TAF (Symtuza)

SULFA

PI class effects

GI effects, lipodystrophy, hyperglycemia, hyperlipidemia (wt. gain), increased risk of MI, increased bleeding, hepatotoxicity ( go thru LIVER)

Contraindicated with RIFAMPIN & ST JOHNS WORT

Don't give with simvastatin or lovastatin

Most w/ food

Norvir

Ritonavir, BOOSTER

Aptivus

Tipinavir

SULFA

BBW INTRACRANIAL BLEEDING, HEPATOXICITY

Tybost

Cobicistat, booster, cyp inhibitor

C/I <70 CrCl

Finasteride dose

5mg daily

Coreg dose/frequency

3.125 bid for first 2 weeks

Isoniazid side effects

flu like symptoms

separate levothyroxine

1 hr before calcium carbonate

selegiline and fluoxetine

potential drug interaction

saquinavir

WITH FOOD

Low hbg and mcv/mch, normal hct

ferrous sulfate

cefotetan effect on INR

WILL RAISE INR

Montelukast adverse effect to report to MD

increased infections

Off-site storage waiver must still retain

the past year of non-controlled prescriptions and the past 2 years of controlled substance prescriptions

If prescriber purchases controlled drug....

The sale must be documented with an itemized

invoice

The concept of preventing medication errors in the pharmacy is BEST characterized by a process that ____

monitors errors over time.

reviews dispensing processes.

A clinical coordinator at a medical center wishes to prepare a quality assurance report on patients receiving tobramycin per pharmacy protocol. What should be documented to assist in evaluating the appropriateness of therapy?

serum creatinine

culture and sensitivity

phenytoin preparations

NS, plastic bag OK

If a burglary occurs within a pharmacy and controlled substances are stolen, the pharmacist must report the loss to the Board of Pharmacy within

30 days

To which of the following may a pharmacy directly sell dangerous drugs or devices without a prescription?

podiatrist

In order to make a generic substitution, a pharmacist must do which of the following?

Notify the patient of the substitution.

thalidomide (Thalomid®)

dofetilide (Tikosyn®)

special education and safeguards upon dispensing

A medication error resulting in serious patient harm has occurred in a hospital, and a root cause analysis is conducted. The results of the analysis indicate that similarity in generic name may have been involved. This should be reported to the

FDA

hospital P&T

A hospital's Pharmacy and Therapeutics Committee decides to retain triamcinolone acetonide 0.1% cream as the medium potency product of choice. Which of the following is a medium potency preparation that should be removed from the formulary?

mometasone 0.1%

A pharmacist is conducting a medication use evaluation to assess the potential adverse effects of metoclopramide. For those patients who received metoclopramide, which of the following would be the MOST APPROPRIATE indicator of severe adverse effects?

the number of patients who received parenteral antihistamines or anticholinergics

A pharmacist wants to document and evaluate the prevalence of Clostridium difficile colitis from antibiotic usage. what should be monitored to obtain the highest yield for identifying this potential adverse drug reaction?

medication orders for oral metronidazole

All iron products prepared in ____

NS

Low Hgb, high MCV

macrocytic anemia→ B12 or folate deficiency

Low Hgb, normal MCV

EPO deficiency

D5W only (ABS NEED DEXTROSE)

Amphoteracin B (all)

Bactrim

Synercid (quinupristin/dalfopristin)

Do not refrigerate

Dexmedetomidine

Sulfamethoxazole/Trimethoprim

Phenytoin-crystallizes

Metronidazole

Moxifloxacin

Furosemide-crystallizes

Enoxaparin

Protect from light

Doxycycline

Epoprostenol

Nitroprusside

Micafungin

Rifampin decreases _____

decreases oral contraception

Zidovudine severe side effect

BONE. MARROW SUPPRESSION

Biktarvy

bictegravir/emtricitabine/tenofovir AF

Triumeq

dolutegravir/lamivudine/zidovudine

Atripla

efavirenz (sustiva) + emtracitabine + tenofovir (TDF)

Thiazolidinediones

No renal adjustment

BBW: CHF

fluid retention, bone fracture

Bladder cancer (pio)

Inc. LDL with rosiglitazone

DPP4 inhibitors

pancreatitis, joint pain

All need renal adjustment except for tradjenta

SGLT2 (flozins)

Bone fractures, UTIS

Inc. LDL, dec. BP

BBW: risk of amputation (canagliflozin)

Alpha glucosidase inhibitors

Acarbose (Precose)

Miglitol (Glyset)

Meglitinides

Repaglinide (Prandin)

Nateglinide (Starlix)

Which sulfonylurea has the highest risk of hypoglycemia?

Glyburide (Diabeta, Glynase)

Nitrofurantoin in UTI/pyelo

Acute cystitis (5 days)

NOT for pyelonephritis or AT TERM pregnancies or if CrCl <30

Bactrim in UTI/pyelo

Cystitis (3 days), pyelonephritis (10-14d), prostatitis

Avoid in pregnancy 1st trimester and at term

Urinary quinolones

Cipro & levo

Reserved for pyelo (10-14d) or prostatitis

AVOID IN PREGNANCY

UTI alternatives

beta-lactams (7d, 14 pyelo); augmentin, cephalexin, cefpodoxime, cefdinir, cefadroxil

Acute cystitis in pregnancy

beta lactams, fosfomycin

Macrobid if pregnancy is not at term

Pyelo in pregnancy

IV ceftriaxone, cefepime, aztreonam

Amoxicillin in otitis media

90mg/kg/day divided into two doses

Oral susp/drops stable for 14d at room temp/fridge

Amoxicillin dental prophy

2g 1 hr prior

Gonorrhea treatment

250 IM + azithro 1g

HTN in pregnancy

Labetalol

CCB (nifedipine)

Methyldopa

NO ACEi/ARB/DRI

MRSA antibiotics

Vanco (1st line)

Clindamycin (IV/oral)

Linezolid (IV/oral)

MRSA skin infection ONLY treatment

Tedizolid (Sivextro)

Delafloxicin (Baxfela)

Dalbavancin (Dalliance)

Oritiavancin (Orbactiv)

Stelara indication

plaque psoriasis, psoriatic arthritis, Crohn's disease and ulcerative colitis

Imiquimod (Aldara) counseling

Apply cream 3/ week for max 16 weeks, qhs. Wash off after 8 hrs

Dabigatran monitoring

renal, adjust to 75mg BID

Enoxaparin administration

SC, abdomen, 90 degree angle, don't expel air bubble

Entresto (sacubitril/valsartan) starting dose

49mg/51mg BID OR 24/26 BID

Simvastatin 80 equivalent dose

20 rosuvastatin

Statin equivalent dosing

RASPLF

rosuva: 5

atorva: 10

simva: 20

prava: 40

lova: 40

fluva: 80

PSK-9 inhibitors

alirocumab, evolocumab, and inclisiran