Pharm Exam 1 Quiz Questions (past & current)

The study of drug absorption, distribution, metabolism, and excretion is known as?

pharmacokinetics

3 multiple choice options

Drug X has a half-life of 5 hours. How much drug is left in the body 20 hours after an IV injection of 1200 milligrams?

75mg

3 multiple choice options

A 88 YO patient is receiving a medication that primarily is excreted through the kidneys. The current dosing is 10mcg every 6 hours. She weighs 140 pounds with a SCr of 1.5. Using the chart below please correctly adjust the patients medication.

Renal adjustment table:

CrCl>75ml/min: 10mcg every 6 hours

CrCl 50-75ml/min: 5mcg every 6 hours

CrCl 30-49ml/min: 5mcg every 8 hours

CrCl <29ml/min: 2.5mcg every 12 hours

Change to 2.5mcg every 12 hours

3 multiple choice options

All of the following medications are CYP inducers EXCEPT?

Erythromycin

3 multiple choice options

In an individual who experiences hypoproteinemia due to cirrhosis of the liver, what effect may they experience when taking a highly bound protein drug such as phenytoin (anti-seizure medication)?

Toxicity

3 multiple choice options

All of the following are examples of miscellaneous clearance EXCEPT?

Renal

3 multiple choice options

Codeine is a prodrug for what medication? What adverse effect may a rapid metabolizer experience when they receive codeine?

Morphine; Respiratory depression

3 multiple choice options

A 62 year old male with a history of hypertension and CHF presents to the clinic with compalaints of severe nausea and vommitting for the past 12 hours. He is unable to keep any food, fluids, or medications down. His current medications are lisonpril and furosemide. His BP is 145/85 and he appears midly dehydrated. Which route of medication administration would be most appropriate for this patient?

IV (intravenous)

3 multiple choice options

Absorption from all of the following undergoe the first pass effect EXCEPT?

Sublingual

3 multiple choice options

What is sometimes used instead of or in addition to serum creatine for kidney assessment?

Cystatin C

3 multiple choice options

Flumazenil (Romazicon) is used to reverse the depressant effects of?

lorazepam

3 multiple choice options

The main pharmacologic effect of venlafaxine is?

Increase levels of serotonin and norepinephrine

3 multiple choice options

You are working in a primary care office. Before you enter a room the nurse states that the patient is here for sexual dysfunction. You enter the room and remember that this was the patient you started on Zoloft about 8 weeks ago. The patient states "she has been unable to achieve orgasm since she started that new medication." What changes can you make to her medication regimen?

Switch her from zoloft to Wellbutrin

3 multiple choice options

Which of the following pairing of generic name and pharmacologic class is incorrect?

Fluoxetine-SNRI

3 multiple choice options

Which of the medications listed below require therapeutic drug monitoring with drawing levels (labs)?

Lithium and Valproic Acid

3 multiple choice options

Which medication may best treat a patient suffering from schizophrenia who also has a history of suicidality, violence, or comorbid substance abuse?

Clozapine

3 multiple choice options

Which of the medications listed below has a novel mechanism of action for treating schizophrenia? It specifically works as a muscarinic agonist.

Xanomeline

3 multiple choice options

A 75 year old woman is tired of taking her valium and wants to come off of it. What is the best course of treatment?

Reduce her dose by 5-25% every 2-4 weeks

3 multiple choice options

Which antidepressant provides more side effects downstream due to less specificity?

Amitriptyline

3 multiple choice options

How does Bupropion's mechanism of action effect dextromethorphan levels?

It inhibits CYP2D6 thus decreasing metabolism of dextromethorphan which increase dextromethorphan levels

3 multiple choice options

Which of the therapies below is used to treat cannabinoid hyperemesis syndrome?

Topical Capsaicin

3 multiple choice options

Medications such a methylphenidate work through the ______________ nervous system which may cause ______________.

sympathetic; hypertension

3 multiple choice options

A patient enters "drug rehab" for their opioid addiction. They are asking about the various medications they can receive to treat their disease. After the initial consultation the patient goes to the restroom. 10 minutes later they are found on the ground in the bathroom. You noticed decreased respirations, meiosis and a faint pulse. Which medication will you give this patient?

Naloxone

3 multiple choice options

Hydromorphone is a schedule ___________ controlled substance and therefore _______ refill(s) are able to be written on a

2; 0

3 multiple choice options

Which of the following pairs of medications is incorrectly paired with its pharmacologic class?

Eszopiclone- benzodiazepine

3 multiple choice options

What medication has the largest amount of "red tape" in order to use it to treat opioid use disorder?

Methadone

3 multiple choice options

You are a PA in charge of rounding in the neonatal intensive care unit. You just completed a physical exam on a 2.5kg premature infant. He has been restless, sneezing, and feeding poorly. You review the tox screen which is positive for opiates. His finnegan score is >12. You plan to start morphine at 1.3 mg/kg/day. How much morphine should this patient receive every 4 hours?

0.54mg

3 multiple choice options

Which of the treatments below are used to treat alcohol withdrawal.

all of these

3 multiple choice options

No more than _____ days of opioids can be prescribed for children with acute pain, in Ohio. Assuming the parents have signed consent and the provider has not documented an exception to the rule.

5

3 multiple choice options

Which of the following is recommended non-psycostimulant pharmacotherapy for cocaine use disorder?

Bupropion

3 multiple choice options

All of the following medications are correctly paired with their route of administrations EXCEPT?

amoxicillin; IV

3 multiple choice options

All of the following are beta-lactamase inhibitors EXCEPT?

Cilastatin

3 multiple choice options

Which medication should not be used to treat pneumonia caused by gram positive organisms such as MRSA?

Daptomycin

3 multiple choice options

All of the following dosing regimens are correct for PCP prophylaxis EXCEPT?

Bactrim 1 DS tab po BID

3 multiple choice options

Which of the medications below has a Black Box Warning for risk of pseudomembranous colitis/Cdiff?

Clindamycin

3 multiple choice options

While taking a patient history, a patients describes to you a reaction in which their face and thorax turned bright red and itchy after being given an IV antibiotic, but cannot remember the name of the drug. They mention it was relieved by benadryl. The infusion rate was reduced and the rest of the infusion was tolerated. What antibiotic would you assume caused the described reaction?

Vancomycin

3 multiple choice options

Which of the antibiotics listed below is the drug of choice when treating ESBL + organisms?

Meropenem

3 multiple choice options

Which of the antibiotics listed below is the drug of choice for treating C. difficile?

Vancomycin PO

3 multiple choice options

Which of the following lab values should be monitored while a patient is taking Daptomycin? Select the answer that is most correct.

CK

3 multiple choice options

What is the dose of doxycycline you would use to treat Chlamydia?

500mg IM x1

3 multiple choice options

What is the term for an antibiotic that that inhibits growth of a bacteria but does not kill the bacteria?

a. bacteriocidal

b. bacterial resistance

c. bacteriostatic

d. beta-lactamse

bacteriostatic

Which of the following is a beta lactam penicillin?

a. Primaxin

b. Zosyn

c. Keflex

d. Maxipime

Zosyn

Which of these ribosomal subunits are not associated with mammalian cells?

a. 80S

b. 40S

c. 60S

d. 30S

30S

While taking a patient history, a patients describes to you a reaction in which their face and thorax turned bright red and itchy after being given an IV antibiotic, but cannot remember the name of the drug. They mention it was relieved by benadryl. The infusion rate was reduced and the rest of the infusion was tolerated. What antibiotic would you assume caused the described reaction?

a. Cefdinir

b. Penicillin VK

c. Vancomycin

d. Bactrim

Vancomycin

What generation of cephalosporins covers MRSA infections?

a. 2nd

b. 5th

c. 6th

d. 1st

5th

Which of the following is a fluoroquinolone agent?

a. Levaquin

b. Macrobid

c. Bactrim

d. Garamycin

Levaquin

Which drug should not be used for a pediatric patient?

a. Azithromycin

b. Doxycylcine

c. Clindamycin

d. Cefdinir

Doxycylcine

Which of the following drug is paired with an INCORRECT class

a. Amoxil- Beta Lactam- Penicillin

b. Keflex- Beta Lactam- Cephalosporin

c. Primaxin- Beta Lactam- Carbapenem

d. Ancef- Beta Lactam- Penicillin

Ancef- Beta Lactam- Penicillin

Nephrotoxicity is an adverse reaction to Aminoglycosides. Which drug if added to an aminoglycoside would increase kidney injury risk?

a. Imipenem/cilastatin

b. Azithromycin

c. Levofloxacin

d. Vancomycin

Vancomycin

Which family of Beta Lactams can be used to treat ESBL?

a. Penicillins

b. Cephalosporins

c. Carbapenems

d. All of the above

Carbapenems

Cilastatin must be co-administered with which medication?

a. Ertapenem

b. Imipenem

c. Piperacillin

d. Amoxicillin

Imipenem

Which of these drugs inhibits protein synthesis by binding to the 30S ribosomal subunit?

a. Doxycycline

b. Azithromycin

c. Linezolid

d. Clindamycin

Doxycycline

Which of these medications may be the drug of choice against a C. difficile infection?

a. Clindamycin PO

b. Vancomycin IV

c. Clindamycin IV

d. Vancomycin PO

Vancomycin PO

Which of the following fluoroquinolone agents is NOT considered a respiratory fluoroquinolone due to poor Streptococcus pneumonia coverage?

a. Levaquin

b. Cipro

c. Avelox

d. None of the above

Cipro

Which of the following is NOT a potential adverse reaction of Bactrim?

a. Hyperkalemia

b. Aplastic anemia

c. Stevens-Johnson syndrome

d. Peripheral neuropathy

Peripheral neuropathy

Which of the following drug is paired with its correct class?

a. Zosyn - Cephalosporins

b. Mefoxin - Penicillins

c. Garamycin - Aminoglycosides

d. Zithromax - Penicillins

Garamycin - Aminoglycosides

All of the following medications are correctly paired with their route of administrations EXCEPT?

A.Penicillin G ; IV

B.Penicillin VK ; PO

C.Amoxicillin ; IV

D.Cefazolin ; IV

Amoxicillin ; IV

All of the following are beta-lactamase inhibitors EXCEPT?

A.Cilastatin

B.Tazobactam

C.Avibactam

D.Clavulanate

Cilastatin

Which medication should not be used to treat pneumonia caused by gram positive organisms such as MRSA?

A.Linezolid

B.Vancomycin

C.Clindamycin

D.Daptomycin

Daptomycin

All of the following dosing regimens are correct for PCP prophylaxis EXCEPT?

A.Bactrim 1 DS tab PO QDay

B.Bactrim 1 SS tab PO QDay

C.Bactrim 1 DS tab PO Mon/Wed/Friday

D.Bactrim 1 DS tab po BID

Bactrim 1 DS tab po BID

Which of the medications below has a Black Box Warning for risk of pseudomembranous colitis/Cdiff?

A.Azithromycin

B.Clindamycin

C.Vancomycin

D.Tobramycin

Clindamycin

Which of the antibiotics listed below is the drug of choice when treating ESBL + organisms?

A. Piperacillin/Tazobactam

B. Cefepime

C. Ertapenem

D. Meropenem

Meropenem

Which of the following drugs is paired with an INCORRECT pharmacologic class?

A. Cefazolin- betalactam- 1st Generation Cephalosporin

B. Ceftriaxone- betalactam- 3rd Generation Cephalosporin

C Cefepime- betalactam- 4th Generation Carbapenem

D. Cefiderocol- betalactam- Siderophore cephalosporin

Cefepime- betalactam- 4th Generation Carbapenem

Which of the antibiotics listed below is the drug of choice for treating C. difficile?

A. Vancomycin IV

B. Vancomycin PO

C. Clindamycin IV

D. Clindamycin PO

E. Daptomycin IV

F. Linezolid PO

Vancomycin PO

Which of these patients would have the highest risk of complications (harm) from codeine use if they were a rapid metabolizer?

a. Pt with chronic renal failure

b. Pt who is currently breast feeding

c. Pt with liver failure

d. Pt who is taking codeine for the first time.

Pt who is currently breast feeding

No more than _____ days of opioids can be prescribed for adults with acute pain, in Ohio.

a. 3

b. 5

c. 1

d. 0

e. 7

7

All of the following are Z drugs except:

a. Ambien

b. Lunesta

c. Restoril

d. Sonata

Restoril

Which of the following is NOT a side effect of opiates binding on a Mu receptor?

a. analgesia

b. dysphoria

c. respiratory depression

d. miosis

dysphoria

Alcohol withdrawal will increase _______ levels, leading to delirium tremens and seizures.

a. glutamate

b. serotonin

c. norepinephrine

d. GABA

glutamate

Which of the following is NOT a side effect of opioid use?

a. respiratory depression

b. miosis

c. diarrhea

d. headache

diarrhea

Which side effect is from NOT from peak withdrawal?

a. hypertension

b. restlessness

c. chills

d. irritability

restlessness

What are some treatments for alcohol withdrawal?

a. benzodiazepine

b. propofol

c. alcohol

d. all of the above

all of the above

What is the MOA of suvorexant (Belsomra)?

a. orexin receptor antagonist

b. GABA agonist

c. glutamate antagonist

d. histamine receptor antagonist

orexin receptor antagonist

Which ADHD medication should NOT be given to children under 6 years old?(Utilize the chart from Slide 30, which is an attachment to this question)

a. Methylphenidate

b. Atomoxetine

c. Modafinil

d. Viloxazine

Viloxazine

A patient has been receiving 4mg of IV hydromorphone in the hospital and is well enough to be discharged. What dose of Codeine should they be sent home on? If indicated consider 50% reduction for incomplete cross tolerance. Round to the nearest 10mg.

270mg

What is the primary MOA for opioids at the presynaptic membrane specifically?

a. Increase calcium influx, enhancing NT release

b. Decrease calcium influx, reducing NT release

c. Activating serotonin receptors, blocking pain signal transmission

d. Increase of potassium influx, hyperpolarizing the membrane

Decrease calcium influx, reducing NT release

Which of the following patients would be indicated to take stimulants?

a. pt with narcolepsy

b. pt with depression

c. pt with binge eating disorder

d. all of the above

all of the above

What is an example of an allergic reaction that would be considered a "true allergy"?

a. nausea

b. anaphylaxis

c. diarrhea

d. all of the above

anaphylaxis

What medication has the largest amount of "red tape" in order to use it to treat opioid use disorder?

a. Methadone

b. Naltrexone

c. Disulfiram

d. Suboxone

Methadone

All of the following are stimulants except for?

a. Methylphenidate

b. Modafinil

c. Lisdexamfetamine

d. Atomoxetine

Atomoxetine

Ethel is a 65 YOF who fell and broke her proximal humerus while baking a pie. Which analgesic should be avoided if she has not taken any opioids over the past 30 days?

a. Fentanyl

b. Morphine

c. Oxycodone

d. Extended-Release Opioids (ER)

Extended-Release Opioids (ER)

Opioid use can cause nausea and vomiting because of the stimulation of what receptors?

a. Delta receptors

b. Delta and Kappa receptors

c. Delta and Mu receptors

d. Kappa and Mu receptors

Delta and Kappa receptors

Which of the therapies below is used to treat cannabinoid hyperemesis syndrome?

A.Pseudoephedrine

B.Ephedrine

C.Cold shower

D.Topical capsaicin

Topical capsaicin

Medications such a methylphenidate work through the ______________ nervous system which may cause ______________.

A.Parasympathetic; hypotension

B.Parasympathetic; hypertension

C.Sympathetic; hypertension

D.Sympathetic; increased salivation

Sympathetic; hypertension

A patient enters "drug rehab" for their opioid addiction. They are asking about the various medications they can receive to treat their disease. After the initial consultation the patient goes to the restroom. 10 minutes later they are found on the ground in the bathroom. You noticed decreased respirations, meiosis and a faint pulse. Which medication will you give this patient?

A.buprenorphine/naloxone

B.Methadone

C.Naloxone

D.Naltrexone

Naloxone

How many schedules are there for controlled substances? The higher the number the_____ addicting a medication is?

A.3; Less

B.4; More

C.5; Less

D.2; More

5; Less

Hydromorphone is a schedule ___________ controlled substance and therefore _______ refill(s) are able to be written on a prescription.

A.1 ; 11

B.1 ; 5

C.2 ; 0

D.2 ; 12

E.3 ; 0

F.3 ; 5

2 ; 0

Which of the following pairs of medications is incorrectly paired with its pharmacologic class?

A. Fentanyl- opioid

B. Eszopiclone- benzodiazepine

C. Temazepam- benzodiazepine

D. Suvorexant (Belsomra)- orexin antagonist

E. Methylphenidate (Ritalin)- amphetamine based stimulant

Eszopiclone- benzodiazepine

What medication has the largest amount of "red tape" in order to use it to treat opioid use disorder?

A. Methadone

B. Morphine

C. Methylphenidate

D. Mirtazapine

Methadone

You are a PA in charge of rounding in the neonatal intensive care unit. You just completed a physical exam on a 2.5kg premature infant. He has been restless, sneezing, and feeding poorly. You review the tox screen which is positive for opiates. His finnegan score is >12. You plan to start morphine at 1.3 mg/kg/day. How much morphine should this patient receive every 4 hours?

A. 3.25 mg

B. 1.3 mg

C. 0.54 mg

D. 0.81 mg

E. the baby does not need morphine, he is just fussy

0.54 mg

Which of the treatments below are used to treat alcohol withdrawal.

A. Lorazepam

B. Phenobarbital

C. Propofol

D. All of these

E. None of these

All of these

No more than _____ days of opioids can be prescribed for children with acute pain, in Ohio. Assuming the parents have signed consent and the provider has not documented an exception to the rule.

A. 3

B. 5

C. 7

D. 30

5

Which SSRI would you not prescribe to a patient with depression who is at a high risk for heart problems?

A. Luvox

B. Celexa

C. Prozac

D. Paxil

Celexa

Which antidepressant has the lowest incidence of sexual dysfunction?

A. Wellbutrin

B. Effexor

C. Cymbalta

D. Lexapro

Wellbutrin

Which SSRI is most selective?

A. Fluoxetine

B. Paxil

C. Lexapro

D. Sertraline

Lexapro

The key difference between SSRI and SNRIs is ___ reuptake

A. dopamine

B. epinephrine

C. serotonin

D. norepinephrine

norepinephrine

Which of these are side effects of SNRIs?

A. GI

B. constipation

C. tachycardia

D. all of the above

all of the above

Because of lag effect, the emotional effects aren't treated until how many weeks out?

A. 1 week

B. 2-3 weeks

C. 5-6 weeks

D. 6-8 weeks

6-8 weeks

A patient presents to your office with a history of irritable bowel syndrome with diarrhea wanting to address her long standing struggle with depression. Which medication would be most suitable to prescribe?

A. Citalopram

B. Paroxetine

C. Venlafaxine

D. Sertraline

Venlafaxine

Which of the following antidepressant medications would ideally promote a desirable outcome for a patient diagnosed with anorexia nervosa and major depressive disorder?

A. Mirtazipine

B. Bupropion

C. Trazodone

D. Vortioxetine

Mirtazipine