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WorksheetsSpring 2022 Milestones
Total questions: 50
Worksheet time: 31mins
What are the brand names of epoetin? Select all that apply.
Epogen
Procrit
Aranesp
Hematocrit
Pronesp
What is the class of Ifex?
Antineoplastic, Alkylating Agent
Hematopoietic Stimulating Agent
Xanthine Oxidase Inhibitor
Iron Chelating Agent
HIV Antiretroviral Agent, Protease Inhibitor
What is the brand name of Ifosfamide?
Ifex
Desferal
Reblozyl
Auvi-Q
Inotropin
What is a brand name for folic acid?
Duragesic
Folacin-800
Uloric
N/A
Aside from Adrenalin, what are the other brand names for epinephrine? Select all that apply.
EpiPen
Auvi-Q
Inotropin
Ifex
Reyataz
Based on its MOA of being an agonist of dopaminergic and adrenergic (alpha and beta-1) receptors, what are physiological effects to be expected following the administration of Intropin? Select all that apply.
Decreased BP
Increased BP
Increased HR
Increased heart contractility
Increased bronchospasm
Which drugs or drug classes, if co-administered with intropin, require urine output monitoring? Select all that apply.
Haloperidol
Diuretics
Inhaled anesthetics
Adrenergic (beta/alpha) blockers
Phenytoin
Why is urine output monitoring needed if haloperidol is co-administered with intropin?
Concurrent use can produce additive or potentiate urine loss
Concurrent use antagonizes effects of norepinephrine
Concurrent use suppresses renal and mesenteric vasodilation
Concurrent use can enhance the risk for arrhythmias
Why is urine output monitoring needed if diuretics are co-administered with intropin?
Concurrent use can produce additive or potentiate urine loss
Concurrent use antagonizes effects of norepinephrine
Concurrent use suppresses renal and mesenteric vasodilation
Concurrent use can enhance the risk for arrhythmias
Why is monitoring needed if beta- or alpha-blockers are co-administered with intropin?
Concurrent use can produce additive or potentiate urine loss
Concurrent use antagonizes effects of norepinephrine
Concurrent use suppresses renal and mesenteric vasodilation
Concurrent use can enhance the risk for arrhythmias
According to the Top 200 Injectable Drug Cards (2021/2022), there are no common ADEs for dopamine use (i.e., occurring in > 10% of patients)
False
True
What should patients alert their providers for when they are given dopamine?
Burning or pain at the site of IV administration
Hallucinations
Disturbing dreams
Increased impulsivity for sex, gambling, or other dangerous activities
All of the above
Based on its MOA of being an agonist of adrenergic (alpha, beta-1, and beta-2) receptors, what are physiological effects to be expected following the administration of Auvi-Q? Select all that apply.
Decreased BP
Increased BP
Increased HR
Increased heart contractility
Decreased bronchospasm
Which of the following drugs/drug classes have a drug-drug interaction with EpiPens ultimately requiring monitoring closely for arrhythmias? Select all that apply.
Cardiac glycosides
TCAs
MAOIs
SSRIs
SNRIs
Aside from potential arrhythmias, what other potential consequence of drug-drug interaction between Auvi-Q and TCAs/MAOIs/linezolid should a healthcare provider also monitor for?
HTN
TENS
ARDS
DM Type II
ODS
Why is monitoring needed if beta- or alpha-blockers are co-administered with Adrenalin?
Concurrent use can produce additive or potentiate urine loss
Concurrent use antagonizes effects of epinephrine
Concurrent use suppresses renal and mesenteric vasodilation
Concurrent use can enhance the risk for arrhythmias
What are some common ADEs (i.e., involving > 10% of patients) involving the use of Adrenalin? Select all that apply.
Sedation
Apprehension
Tremor
Seizures
Nausea/Vomiting
Which of the following are valid counseling points involving the use of epinephrine? Select all that apply.
Inform provider about burning or pain at the site of IV administration
Inject into the outside thigh with the leg firmly held during administration; do not inject into the buttocks, fingers, hands, or feet.
Follow autoinjector instructions per manufacturer and seek medical assistance immediately even if you feel better after use.
Autoinjectors are to be used only IM or SQ
Do not use if you are also taking nitrates for chest pain
What are true statements regarding the differences and similarities of darbepoetin and epoetin's MOA? Select all that apply.
Darbepoetin alfa is a hyperglycosylated analogue of recombinant human erythropoietin.
Epoetin alfa is recombinant human erythropoietin
Only darbepoetin alfa binds to the erythropoietin receptor of erythroid progenitor cells
Both darbepoetin alfa and epoetin alfa both result in the stimulation and differentiation of mature RBCs
How do you manage the drug-drug interaction between epoetin and thalidomide, assuming both drugs require coadministration? Select all that apply.
Avoid concurrent use
Consider adding anticoagulative therapy if coadministration is necessary
There is no drug-drug interaction between epoetin and thalidomide
Monitor INR
Separate use by 4-6 hours apart
Which of the following are common (i.e., occurring in > 10% of patients) ADEs of epoetin? Select all that apply
Edema
Injection site thrombosis
Pruritus
Pure red cell aplasia
Tumor progression
Which of the following are key counseling points for epoetin? Select all that apply.
This medication must not be shaken, diluted, or exposed to light.
This medication must be stored in its box in the fridge, but not frozen.
Vials are single use only; do not combine remaining epoetin from different vials
For maximal effects to be seen, it may require several weeks of therapy
This medication can be administered orally and rectally
What is febuxostat's class?
Xanthine oxidase inhibitor
Anticoagulant
Antineoplastic, alkylating agent
Hematopoietic stimulating agent
Antiretroviral agent, CCR5 antagonist
Which of the following substrates for xanthine oxidase is contraindicated for concurrent use with febuxostat? Select all that apply
Azathioprine
Didanosine
Mercaptopurine
Theophylline
Xanthan gum
Which of the following substrates for xanthine oxidase is can be used with caution concurrently with febuxostat? Select all that apply
Azathioprine
Didanosine
Mercaptopurine
Theophylline
Xanthan gum
According to the Top 200 Injectable Drug Cards (2021/2022), there are no common ADEs for Uloric use (i.e., occurring in > 10% of patients)
False
True
Which of the following statements are valid key counseling points for Uloric? Select all that apply.
Take with food
Lifestyle modifications (limiting alcohol consumption and weight loss) is recommended for all gout patients
Seek medical attention for severe mood swings, rashes, or abnormal heart beat
Do not take with grapefruit juice
Take without food
Which of the following drug classes, if taken concurrently with fentanyl, can result in additive CNS depression? Select all that apply.
Barbiturates
Benzodiazepines
Centrally-acting muscle relaxers
Opioids
Phenothiazines
What can occur if fentanyl is concurrently used with either beta-blockers or calcium channel blockers?
Additive hypotension
Additive respiratory depression
Precipitation of withdrawal symptoms
Additive CNS depression
Increased risk of serotonin syndrome
What is the management strategy to prevent the precipitation of withdrawal symptoms in patients taking fentanyl and either buprenorphine, opioid antagonists, or mixed opioid agonist/antagonists?
Avoid concurrent use
Separate use by 2 hours
Monitor for increased CNS/respiratory depression
Consider dose increases of fentanyl
Administer probenecid
Which of the following are common (i.e., present in > 10% of patients) ADEs of fentanyl transdermal? Select all that apply
Application site reactions
Constipation
Urinary retention
Sweating
Confusion
What can potentially increase absorption of fentanyl from its transdermal patch?
Broken skin
Fever
Alcohol consumption
Pregnancy
Constipation
Which of the following statements are valid key counseling points for fentanyl transdermal?
Stimulant laxatives are recommended for the treatment of medication-induced constipation
Avoid driving or other tasks requiring motor coordination
Old patches must be removed when new patches are applied
Skin where the patch will be applied to must be clean and dry with no breaks
Alcohol is recommended to be consumed concurrently while using fentanyl transdermal patches.
What type of anemia is caused by folate deficiency?
Normocytic
Macrocytic
Microcytic
Aplastic
Sickle-cell
Which of these drugs/drug classes not only decrease folic acid absorption, but also suffer from decreased efficacy (due to increased metabolism) if concurrently taken with folic acid?
Barbiturates
Phenytoin
Valproic Acid
Opioids
Cocaine
Which of the following is a common (i.e., occurring in > 10% of patients) ADEs of folic acid? Select all that apply
Loss of appetite
Anaphylaxis
TENS
Serotonin syndrome
Priapism
Which of the following are appropriate counseling points for folic acid? Select all that apply.
Avoid alcohol, as this inhibits folic acid absorption
Effects occur immediately upon taking first dose
Several weeks of therapy may be required for maximal effect
May cause drowsiness
May cause changes in vision
Heparin potentiates antithrombin III activity; this leads to the inactivation of thrombin and prevents the conversion of fibrinogen to fibrin.
False
True
How should you manage the concurrent use of heparin and other anticoagulants (e.g., DOACs, such as rivaroxaban)?
Avoid concurrent use
Monitor for signs and symptoms of bleeding
How should you manage the concurrent use of heparin and antiplatelet agents (e.g., prasugrel)?
Avoid concurrent use
Monitor for signs and symptoms of bleeding
What drugs can cause thromboses and thus counteract the effects of heparin?
Estrogen/Progestin Derivatives
Testosterone
Folic Acid
Aspirin
Opioids
What are common (i.e., occurring in > 10% of patients) ADEs related to heparin use? Select all that apply.
Hemorrhage
Thrombocytopenia
Pulmonary embolism
Stroke
Deep vein thrombosis
What are valid key counseling points related to the use of heparin?
For SQ administration, do not administer into muscle, since pain, irritation, and bruising (hematoma) can occur.
Continuous IV infusions can be diluted in NS, 1/2NS, and D5W and be given through an infusion pump
Bleeding can occur during or after administration
This medication can be frozen
This medication can be administered as a rectal enema
What mechanisms give Ifex its antineoplastic activity?
Crosslinking DNA strands
Inhibition of protein synthesis
Inhibition of DNA synthesis
All of the above
What are the CYP enzymes that primarily metabolizes Ifex (and therefore, must be wary of co-administered inducers and inhibitors?)
CYP3A4/5
CYP1A2
CYP2C8/9/19
CYP2D6
What is the management strategy for patients taking ifosfamide and other immunosuppressive agents concurrently?
Avoid concurrent use
Separate use by 2 hours
Monitor for increased CNS/respiratory depression
Complete all needed vaccines 2 weeks prior to starting ifosfamide
Administer probenecid
What are the most common (i.e., occurs in > 10% of patients) ADEs related to ifosfamide use? Select all that apply.
Alopecia
Anemia
Leukopenia
CNS toxicity
Nausea/Vomiting
What are appropriate key counseling points for ifosfamide? Select all that apply.
This drug can cause infertility in both men and women
Alopecia, nausea/vomiting, and myelosuppression are common.
This drug can cause non Hodgkin's lymphoma
Bladder toxicity can be mitigated especially with adequate hydration
This drug can cause acute kidney injury
Which drugs/drug classes not only decrease folic acid serum levels but also suffer from decreased efficacy if concurrently taken with folic acid?
Barbiturates
Phenytoin
Valproic Acid
Opioids
Cocaine
Fentanyl is _____ to/than morphine.
equipotent
5-10x more potent
50-100x more potent
5-10x less potent
50-100x less potent
