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PRACTICE

Medicine

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227 Terms

1

What does the abbreviation NPO mean?

Nothing by Mouth

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2

What is the brand name for Eszopiclone?

Lunesta (a hypnotic used to treat insomnia)

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3

Which section provides the Medicare prescription drug benefit?

Medicare Part D (federal government program that subsidizes the cost of prescription drugs and drug insurance premiums for Medicare Recipients)

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4

Which of the following is NOT a Schedule 1 narcotic? OxyContin Heroin Marijuana Ecstasy

OxyContin (OxyContin is a Schedule 11 medication, there have been numerous proposals to remove marijuana from Schedule 1, but the federal government has declined to make this change)

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5

This is an autoimmune disease in which the thyroid is overactive, and produces excessive amounts of thyroid hormones:

Grave's Disease (most common cause of hyperthyroidim)

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6

If a physician writes an order for 400 mL of D5W to be infused over a 4-hour time period, and the IV drop factor is 12 gtt/mL, how many drops per minute should be delivered?

20 gtt

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7

If two drugs are taken together and one of them intensifies the action of the other, what type of drug interaction has occurred?

Potentiation

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8

Antagonism

When two drugs work against each other

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9

Synergism

When the effect of two drugs together is greater than the sum of their individual effects.

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10

Additive Effects

When the effect of two drugs together is equal to the sum of their individual effects.

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11

Which of these herbal medications can be used to treat anxiety? Garlic Kava Milk Thistle Acai

Kava (sedating agent and is usually consumed in order to relax without disrupting mental clarity)

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12

A drug sells for $29.99 retail and has a wholesale cost of $19.74. The dispensing cost is $3.20. What is the pharmacy's net profit?

$7.05

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13

Which of the following medications is NOT used to treat high cholesterol? Vytorin Crestor Zetia Nexium

Nexium (used to treat GERD)

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14

What is the generic drug suffix for a proton pump inhibitor?

PRAZOLE

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15

You are planning to prepare 600 mL of 20% dextrose solution, by mixing your 5% and 50% dextrose solution. How much of each solution will be needed?

200 mL of the 50% and 400 mL of the 5%

This is an alligation problem, so you will put 50 in the upper left of your tic-tac-toe table, 5 in the lower left, and 20 in the middle. Subtracting across the middle you will put 15 in the upper right and 30 in the lower right. So you need 15 parts of the 50% and 30 parts of the 5%, for a total of 45 parts.

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16

The action of reducing a material to small particles is:

Comminution (There are 3 methods for comminution: trituration, pulverization by intervention, and levigation)

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17

What is DEA form 222 used for?

To order Schedule 11 medications (Form 222 is a triplicate order form for schedule 1 and 2 controlled substances. The purchaser submits copy 1 and 2 to the supplier and keeps copy 3 on file. When the order arrives, the number of packages received must be written on the form along with the date. This form is then kept on file for at least 2 years.)

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18

74 degrees Fahrenheit is equal to what temperature in Celsius?

23.3 C

To convert from Fahrenheit to Celsius, subtract 32 from the Fahrenheit temperature and then divide by 1.8.

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19

This law defined two specific categories for medications: prescription and over-the-counter.

Until the Durham-Humphrey Amendment was passed, there was no requirement that any drug be labeled for sale by prescription only. The amendment defined prescription drugs as those unsafe for self-medication and which should therefore be used only under a doctor's supervision.

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20

The Red Book is a resource that focuses on:

Drug pricing

(The Red Book is the leading resource for information on drug pricing.)

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21

A list of medications available for use within a health care system is called a:

Formulary

The primary function of a prescription formulary is to specify particular medications that are approved to be prescribed under a particular insurance policy. Formularies are developed by evaluating the safety, efficacy, and cost-effectiveness of various drugs. With a closed formulary the insurance policy won't pay for drugs that are not on the list. An open formulary allows drugs that are not on the list, but will generally charge a higher co-pay for those drugs.

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22

Tall man letters are used for drugs which:

Have look-alike names

Several studies have shown that highlighting sections of drug names using tall man (mixed case) letters can help distinguish similar drug names, making them less prone to mix-ups. The tall man letters are used to help draw attention to the dissimilarities in drug names. For instance Celexa would be written as CeleXA to avoid confusion with CeleBREX. The Institute for Safe Medical Practices (ISMP), the FDA, and the Joint Commission promote the use of tall man letters as one method of reducing confusion between similar drug names.

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23

The pharmacy technician notices that a dosage may be typed wrong in the system. The reading says 0.1g but it should probably be 0.01g as 0.1 may be too large of a dose. What should the technician do in this case?

Alert the pharmacist to verify.

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24

A drug is recalled by the FDA, but the problem is unlikely to cause any adverse health reactions. What type of recall would this be?

Class 111

Class I recalls are the most serious type. Class II recalls are for less serious problems, such as temporary adverse health consequences. Class III recalls are for situations in which adverse health consequences are unlikely.

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25

According to federal law, DEA forms need to be maintained for ____ years.

2

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26

Laminar flow hoods must be certified every ___ months.

6

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27

Which of the following is NOT used to treat insomnia? Xanax Ambien Chantix Lunesta

Chantix (used to treat nicotine addiction)

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28

What is the brand name for aripiprazole?

Abilify (aripiprazole) is an antipsychotic.

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29

Convert 5.5 kg to pounds.

12.1 lbs (Recall that a kilogram is equal to 2.2 pounds)

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30

An order is written to administer 2 liters of an IV fluid over 18 hours. What will the flow rate be?

111 mL/hr

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31

What type of drug is loratadine?

Antihistamine (commonly used to relieve allergies.)

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32

The percent equivalent of 1:125 ration is:

0.8%

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33

An order is written for 500 mL of NS to infuse at 40 gtt/min. How long would it take to infuse the NS if the set delivers 10 gtt/mL?

125 minutes

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34

If a drug has no accepted medical use and extremely high potential for abuse, which DEA schedule would it be categorized in?

Schedule 1 (includes drugs such as Marijuana, Ecstasy, Peyote, and Heroin)

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35

On which of these would you find information about the pharmacology of a drug?

A PPI (patient package insert) is a document provided along with a prescription medication to provide additional information about that drug. The first section lists the brand name and generic name of the product. The other sections cover clinical pharmacology, indications, contraindications, warnings, precautions, adverse reactions, drug abuse and dependence, overdosage, dosage and administration, and how supplied. The clinical pharmacology section tells how the medicine works in the body, how it is absorbed and eliminated, and what its effects are likely to be at various concentrations.

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36

What is a common side effect of warfarin?

Internal Bleeding (Warfarin is an anticoagulant. It is used to prevent the formation of blood clots. The only common side effect is hemorrhage [bleeding] )

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37

This federal law requires pharmacists to review Medicaid recipients' entire drug profile before filling their prescriptions.

Omibus Budget Reconciliation Act of 1990

OBRA-90 placed regulations on the pharmacist in how to interact with the patient, with a goal of improving therapeutic outcomes. The law includes prospective drug utilization review (ProDUR) requirements, counseling obligations, and record-keeping mandates.

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38

Schedule 11 medications must be stored in:

Locked Safe

All schedule II substances should be stored in a locked safe, while schedule III, IV and V may be stored throughout the pharmacy.

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39
What is the proper hand washing guideline in USP <797\>?
Wash hands and forearms to the elbow for at least 30 seconds.

USP <797\> Hand Hygiene Procedure: 1) Remove debris under fingernails with nail cleaner and warm water. 2) Wash hands and forearms to the elbow for at least 30 seconds with soap and water. Be vigorous and thorough. 3) Do not use antimicrobial scrub brushes on the skin because they can damage the skin and increase skin shedding. 4) Dry hands and forearms completely using lint-free disposable wipes or an electric hand dryer.
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40

What is DEA Form 41 used for?

To document the destruction of controlled substances.

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41

Which of the following is a non-prescription medication used to treat insomnia? Temazepam Glucosamine Melatonin Zolpidem

Melatonin

Glucosamine is a non-prescription medication used to treat arthritis symptoms. Zolpidem and temazepam are prescription medications used to treat insomnia.

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42

What type of drug is omeprazole?

Proton pump inhibitor

Prilosec (omeprazole) is a proton pump inhibitor that is used to treat gastroesophageal reflux disease.

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43

What is the maximum capacity for a class A balance?

120 g

The minimum weight that can be weighed on a Class A Prescription Balance is 120 mg and the maximum weight is 120 g. The sensitivity is 6 mg, meaning that 6 mg of a substance will move the pointer of the balance one division off equilibrium, or one degree.

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44

Which of these is an antihistamine? Fluconazole Lisionpril Fexofenadine Losartan

Fexofenadine is an antihistamine with the brand name Allegra.

Lisinopril is an ACE inhibitor. Losartan is an angiotensin II receptor antagonist. Fluconazole is an antifungal.

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45

Which statement is true of PPO plans?

PPO plans provide substantial discounts for doctors and hospitals in the network. When using out-of-network providers, PPO members are reimbursed at a reduced rate. With a PPO, members can see the doctor or specialist they like without having to see a PCP first. PPO premiums tend to be higher than HMO plans, and there is usually a deductible.

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46

Which Act of Congress addresses the privacy and security of health data?

Health Insurance Portability and Accountability Act of 1996.

The HIPAA Privacy Rule provides federal protections for personal health information and gives patients an array of rights with respect to that information.

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47

Which of the following correctly matches brand/generic names? Ativan/levaquin Zyrtec/diphenhydramine Cymbalta/duloxetine Paxil/pregabalin

The generic name for Cymbalta is duloxetine.

The generic name for Paxil is paroxetine. The generic name for Zyrtec is cetirizine. The generic name for Ativan is lorazepam.

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48

The FDA publishes a book called Approved Drug Products with Therapeutic Equivalence Evaluations, which is more commonly known as the:

Orange Book

The Orange Book identifies drug products approved on the basis of safety and effectiveness by the FDA. It also contains therapeutic equivalence evaluations for generic drugs, using Therapeutic Equivalence codes such as AA, AB, BC, and BD. If the first letter of the code is an 'A', the FDA has concluded that the generic formulation is therapeutically equivalent to the reference drug. If the first letter is a 'B', the FDA has concluded that the compared drugs are not equivalent. The second letter of the code gives more detailed information about formulations. The Orange Book also lists the patents which are purported to protect each drug.

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49

Which part of the NDC number indicates the manufacturer of a drug?

The first 4-5 digits

The labeler code is the first segment. It is 4-5 digits and identifies the manufacturer. The product code is the second segment and is 3-4 digits long. It identifies the formulation, strength, and dosage. The package code is the third segment. It is 1-2 digits and identifies the package forms and sizes.

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50

The iPLEDGE program is designed to mitigate the risks associated with taking:

Isotretinoin

Isotretinoin is a medication primarily used to treat cystic acne. Common brands include Absorica, Accutane, Amnesteem, Claravis, Epuris, Isotroin, and Roaccutane. iPLEDGE is a mandatory distribution program that is intended to prevent the use of isotretinoin during pregnancy, due to the high risk of birth defects.

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51

Which of the following is NOT a medication for Parkinson's? Benztropine Ropinirole Amantadine Amlodipine

Norvasc (amlodipine) is a calcium channel blocker that is used to lower blood pressure and prevent chest pain.

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52

A prescription calls for 25mg of a medication t.i.d. for 7 days. The stock solution is composed of a 100mg/3mL. How many Liters of the stock solution is needed for the order?

0.01575 L (or 15.75 mL)

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53

T.I.D

Three times daily

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54

How many digits is a BIN number?

6

The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended American National Standards Institute (ANSI) Issue Identifier Number (IIN) for processing electronic pharmacy claims. ANSI issues IIN numbers. NCPDP issues the Processor ID Number (BIN).

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55

Which is the proper use of tall man letters to help differentiate these look-alike/sound-alike medications? PARoxetine — FLUoxetine PAROXetine — FLUOXetine parOXETINE — fluOXETINE paroxeTINE — fluoxeTINE

PARoxetine — FLUoxetine

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56

The process by which a health insurance company determines if it should be the primary or secondary payer of medical claims for a patient who has coverage from more than one health insurance policy:

Coordination of benefits is important when a patient is covered by more than one insurance plan. Medicare is often one of the plans involved with COB.

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57

Which of the following covers inpatient hospitals stays?

Medicare Part A covers inpatient hospital stays, including a semiprivate room, food, and tests. The maximum length of stay that will be covered is usually 90 days.

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58

What is DEA form 106 used for?

Theft or loss of controlled substances

Written notification must be provided to the DEA Field Division Office of the theft or significant loss of any controlled substance within one business day of discovery of the loss. DEA form 106 must be completed and submitted to the Field Division Office.

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59

Which federal law introduced a 'proof-of-efficacy' requirement?

The Kefauver Harris Amendment - also known as the 'Drug Efficacy Amendment' - is a 1962 amendment to the Federal Food, Drug, and Cosmetic Act. It introduced requirements for drug manufacturers to provide proof of the effectiveness and safety of their drugs before they could be approved. It also required drug advertising to disclose accurate information about side effects and efficacy of treatments.

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60

Individuals with a severe allergy to penicillin SHOULD NOT receive

ciprofloxacin doxycycline azithromycin amoxicillin

Amoxicillin is contraindicated and should be avoided, while the other options given here are considered safe. Other antibiotics to avoid include Augmentin, Flucloxacillin, Penicillin G, Penicillin V, Tazocin, Temocillin, and Timentin. Other drugs that are on the caution list and should also be avoided include all cephalosporins (Cefalexin, Cefixime, Cefotaxime, Ceftazidime, Ceftriaxone, Cefuroxime) and all carbapenems (Ertapenem, Imipenem + Cilastatin, Meropenem) and Aztreonam.

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61

How much dextrose is in a 900mL solution of D5W?

D5W means 5% dextrose in the solution. Calculate: 5% of 900 = 45 g

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62

Which of the following potential hazards are addressed by OSHA regulations?

OSHA regulations address the following potential hazards in a pharmacy: Exposure to bloodborne pathogens (HIV, Hepatitis B & C), exposure to hazardous chemicals or drugs, exposure of eyes or bodies to corrosive materials, exposure to latex allergy, exposure to wet surfaces that could cause slip and falls, and availability of personal protective equipment.

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63

Bar Code Medication Administration (BCMA) is a system designed to:

The BCMA system is used by nurses in healthcare settings who are administering medications. With this system the nurse can scan a barcode on the patient's wristband to make sure it is the right patient. Then the nurse scans a barcode on the medicine to ensure it is: the right medicine, the right dose, the right time, and is administered by the right route.

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64

Which of the following is NOT a diuretic?

pioglitazone spironolactone Maxide furosemide

Pioglitazone is a hypoglycemic agent.

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65

How is 34 written in roman numerals?

XXXIV

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66

Convert this roman numeral to a number: LII

52

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67

A 30 mL dose of nighttime cough suppressant contains 12.5 mg of doxylamine succinate. How many milligrams of doxylamine succinate are in the entire 354 mL bottle?

147.5

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68

The pharmacy technician can reconstitute a 100 mL bottle of Amoxycillin in 50 seconds. How many of these bottles can the technician reconstitute in 30 minutes?

36

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69

The pharmacy recieves a controlled substance order from their wholesaler. There are a total of 435 pills. Of this total, 17% are C2, 19% are C3, 20% are C4, and 44% are C5. How many C3 pills were in the order?

83

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70

Of all the prescriptions received at the pharmacy last Tuesday, 892 were refills. The remainder were new prescriptions, with 168 from patient drop-offs, 183 coming in electronically, and 69 coming in by phone. What percentage of the total prescriptions received were new drop-offs?

12.8%

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71

A patient comes to the pharmacy counter with a prescription for Amoxicillin 250mg/5mL and the directions indicate 1¼ tsp po bid x 10d. What is the total quantity needed for dispensing?

125mL

Recall that 1 teaspoon equals 5 mL. So 1¼ teaspoons equals 6.25 mL. Since it is twice a day (bid) for 10 days you must calculate: 6.25 × 2 × 10 = 125 mL

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72

What volume of a drug for injection 100mg/45mL should be used for 250mg?

112.5mL

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73

The pharmacist is preparing 200 mL of a famotidine suspension containing 75mg/5mL. How many 20 mg tablets of famotidine will be needed?

150 tablets

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74

You need 800 mL of 10% dextrose solution. How much of your 50% and 5% dextrose solution will you need to mix?

This is an alligation problem, so you should setjup a tic-tac-toe table. The highest concentration goes in the upper left corner and the lowest concentration in the lower left corner. The desired concentration goes in the middle: 50% | | | 10% | 5% | |

Subtract diagonally across the middle, making sure you subtract the smaller number from the larger number. Add the word 'parts' next to the result: 50% | | 5 parts | 10% | 5% | | 40 parts

Now the number of parts needed for each concentration is lined up across the table: 50% | -> | 5 parts | 10% | 5% | -> | 40 parts

So you need 5 parts of the 50% and 40 parts of the 5%, for a total of 45 parts.

Amount of 50% needed will be: 5/45 × 800 = 89 Amount of 5% needed will be 40/45 × 800 = 711

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75

How is 59 written in roman numerals?

LIX

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76

Convert this roman numeral to a number: CXXVI

126

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77

Which of the following quantities will fill a 16 ounce container the most without causing any overflow?

465 mL

Recall that 1 oz = 30 mL. So 16 oz = 480 mL. Of these answers choices 485 mL is the closest to 480 mL, but that would cause overflow. The next lowest answer is correct, 465 mL.

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78

A bottle of fluticasone propionate nasal spray provides 120 metered sprays. Each spray delivers 50 mcg of fluticasone propionate in 100 mg of formulation through the nasal adapter. A prescription is filled for, "Three bottles, 2 sprays each nostril, qd." How many days will this supply last?

90 days

Since the prescription states 2 sprays per nostril, and people have 2 nostrils, there will be 4 four sprays per day (qd is the abbreviation for daily). Each bottle has 120 sprays, so each bottle will last for: 120 ÷ 4 = 30 days Since there are 3 bottles: 3 × 30 = 90 days

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79

A bottle with 236 milliliters of liquid allergy medication contains Diphenhydramine HCl 12.5mg/5mL. How milligrams of Diphenhydramine HCl are in the bottle?

590 mg

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80

A bottle with 8 fluid ounces of liquid allergy medication contains 590 mg of Diphenhydramine HCl. How many grams of Diphenhydramine HCl are in 1 gallon of this medication?

9.44 g

There are two steps to solve this problem. Convert the milligrams in 8 fluid ounces to gallons, and then convert from milligrams to grams. Recall that there are 8 fluid ounces in a cup. Which means there are 16 fluid ounces in a pint, 32 fluid ounces in a quart, and 128 fluid ounces in a gallon. How many cups are in a gallon? 128 ÷ 8 = 16 Multiply 590 mg by 16 to figure out how many mg are in 1 gallon: 590 × 16 = 9,440 mg The question asks for grams. There are 1,000 mg in 1 gram: 9,440 ÷ 1,000 = 9.44 grams

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81

A child's prescription for ceftriaxone is 50mg/kg per day in equally divided doses every 12 hours. How many grams of the drug will be administered over the first 5 days if the child weighs 80 pounds?

9

The first step to solving this is to convert the child's weight to kilograms. Recall that 1 pound is equal to 0.454 kilograms: 80 lbs ⋅ 0.454 kg / 1 lbs = 36.32 kg The child's weight can be rounded to 36 kg. Since the daily dose is 50mg / kg, the child's weight can be multiplied by 50: 36kg ⋅ 50 mg / kg = 1,800 mg (per day) Over 5 days: 5 × 1,800 = 9,000 mg The final step is to convert this to grams: 9,000mg ⋅1 g / 1,000mg = 9 g

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82

The pharmacy technician knows that 600 mL of 20% dextrose solution contains _____ grams of dextrose.

120 g

To answer this type of problem you must know that percentage strength is conventionally given as weight to volume (w/v), where 20% means: 20 g / 100 mL The problem can be solved by setting up a proportion: x g / 600 mL = 20 g / 100 mL (100)(x) = (600)(20) 100x = 12,000 x = 120 g

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83

What is the generic name for Januvia?

Sitagliptin: an antihyperglycemic that is used in the treatment of diabetes.

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84

What is the generic name for Lexapro?

Escitalopram: an antidepressant that is used to treat major depressive disorder and generalized anxiety disorder.

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85

What is the generic name for Levaquin?

Levofloxacin: an antibiotic that is used to treat a variety of bacterial infections.

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86

What is the generic name for Coreg?

Carvedilol: a medication used to treat high blood pressure and congestive heart failure.

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87

What is the generic name for Symbicort?

Budesonide/Formoterol: a combination drug that is used in the management of asthma and COPD.

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88

What is the generic name for Abilify?

Aripiprazole: an antipsychotic that is used to treat schizophrenia and bipolar disorder.

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89

What is the generic name for Celebrex?

Celecoxib: a nonsteroidal anti-inflammatory drug (NSAID) that relieves pain and inflammation. It is used to treat arthritis and acute pain.

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90

What is the generic name for Seroquel?

Quetiapine: an antipsychotic used to treat schizophrenia, bipolar disorder, and major depressive disorder.

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91

What is the generic name for Vytorin?

Ezetimibe/Simvastatin: a combination drug used to lower the production of cholesterol and the absorption of cholesterol.

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92

What is the generic name for Synthroid?

Levothyroxine: a synthetic thyroid hormone that is used to treat thyroid hormone deficiency.

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93

What is the generic name for Protonix?

Pantoprazole: a proton pump inhibitor used for the treatment of stomach ulcers.

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94

What is the generic name for Xalatan?

Latanoprost: administered into the eyes to control the progression of glaucoma or ocular hypertension by reducing intraocular pressure.

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95

What is the generic name for Mobic?

Meloxicam: a non-steroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation in rheumatic diseases and osteoarthritis.

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96

What is the generic name for Tamiflu?

Oseltamivir: an antiviral medication that is used to treat influenza (flu).

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97

What is the generic name for Cialis?

Tadalafil: used to treat erectile dysfunction.

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98

What is the generic name for Cozaar?

Losartan: mainly used to treat high blood pressure.

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99

What is the generic name for Effexor XR?

Venlafaxine: an anti-depressant that is used to treat major depressive disorder, generalized anxiety disorder, panic disorder, and social phobia.

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100

What is the generic name for TriCor?

Fenofibrate: is used to reduce cholesterol levels in people at risk of cardiovascular disease.

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