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WorksheetsORION 94-110
Total questions: 125
Worksheet time: 1hrs 3mins
What are the major constituents of the fungal cell wall?
chitin
glucans
glycoproteins
peptidoglycan
Vancomycin trough level?
5–10 mg/L
10–20 mg/L
30–40 mg/L
Target vancomycin trough in severe infection?
5–10 mg/L
15–25 mg/L
15–20 mg/L
Your colleague has had contact with a Clostridioides difficile patient and used disinfectant wipes. What should be done?
Use alcohol
Wash hands
Take tetracycline
Vancomycin optimum trough concentration (mg/L).
5–10
10–15
15–20
Cyclosporine is given. Which medication is safe to give with it?
Azithromycin
Erythromycin
Clarithromycin
Pregnant patient with HIV and viral load < 100 . Which medication is given in delivery?
Tenofovir
Lamivudine
Zidovudine
Efavirenz
Gentamicin peak?
one hour after dose
two hours before dose
one hour before dose
Mechanism of azole antifungals in fungi?
inhibition of ergosterol synthesis
bind to the membrane of fungi
induce in the membrane and destroy it
Ciprofloxacin reaches which tissues first?
liver, adipose tissue, brain
brain, liver, adipose tissue
adipose tissue, liver, brain
Tetracycline accumulation occurs where?
bone
liver
tissue
What is endotoxin?
part of gram-positive bacteria
part of gram-negative bacteria
heat labile
What is exotoxin?
found in both gram-positive and gram-negative bacteria
part of gram-positive bacteria
part of gram-negative bacteria
heat labile
Best treatment for Staphylococcus aureus–positive mastitis?
cephalexin
nitrofurantoin
clindamycin
ciprofloxacin
Patient taking vancomycin: when should the nurse withdraw a trough vancomycin level?
1 hour before the scheduled vancomycin dose
30 minutes after vancomycin administration
30 minutes before the 4th dose
30 minutes before vancomycin administration
After tooth extraction, antibiotic prophylaxis for endocarditis is most needed for which condition?
mitral valve disease
kidney transplant
asthma
diabetes
Ebola effect?
common cold
hemorrhagic fever
pulmonary edema
atypical pneumonia
A 2-year skin infection in a patient with penicillin allergy: which treatment should be taken?
doxycycline
amoxicillin + clavulanic acid
sulfamethoxazole + trimethoprim
Which bacteria cause milk fermentation?
Lactobacillus
Bacteroidetes
Chlamydia
Cyanobacteria
Which antibiotic causes hyperkalemia?
ciprofloxacin
norfloxacin
trimethoprim/sulfamethoxazole
amoxicillin
Pseudomonas aeruginosa appearance in Gram stain?
gram-positive cocci
gram-negative cocci
gram-positive bacilli
gram-negative bacilli
Immunoglobulin analysis shows positive IgG and IgM. What is the type of infection?
an old infection
the condition worsened
new condition
the earliest new case does not appear with the new infection A
Which of the following is an appropriate empiric treatment for meningitis?
vancomycin
ceftriaxone 2 g every 12 h IV for 7 – 14 days
ampicillin
azithromycin
Epileptic patient on phenytoin: which antibiotic is suitable?
ciprofloxacin
erythromycin
azithromycin
clarithromycin
Transmission of Brucella species?
ingestion of unpasteurized milk or milk products
aerosolized spores in hospital rooms
person-to-person contact
mosquito bite
Most effective infection control in hospital?
wearing gloves
wearing mask
do not contact infected patients
everyone entering hospital must wear PPE
Antibiotics that inhibit protein synthesis by binding to the 30S subunit at site A inhibit which process?
initiation of protein synthesis
elongation of protein synthesis
termination of protein synthesis
Antibiotics that inhibit protein synthesis by binding to the 50S subunit at site A inhibit which process?
initiation of protein synthesis
elongation of protein synthesis
termination of protein synthesis
Patient with E. coli UTI received TMP/SMX, but the organism is resistant. What is the most appropriate alternative?
ciprofloxacin
meropenem
TMP/SMX double strength
Clostridioides difficile causes which condition?
salmonellosis
typhoid fever
pseudomembranous colitis
cholera
Which type of cephalosporin has the least effect on Pseudomonas aeruginosa?
cefazolin
cefoxitin
ceftazidime
cefiderocol
A 65-year-old diabetic man is admitted to the emergency department with a 3-day history of productive cough, shortness of breath, and chest pain. Chest X-ray shows bilateral lower infiltration. An H1N1 virus was detected in a nasal swab. Which of the following antivirals is the drug of choice in this case?
ribavirin
acyclovir
oseltamivir
ganciclovir
Which of the following drugs exhibits dose-dependent pharmacokinetics at normal therapeutic doses?
lithium
quinidine
phenytoin
sodium valproate
The ionization of the drug is very important to understand the pharmacodynamic of the drug. Which of the following forms are absorbed from the stomach?
polar-ionized
polar-ununionized
non polar ionized
non-polar-unionized
How long does it take for the body to remove 99% of the drug by first-order elimination after a single dose?
2 half-lives
4 half-lives
7 half-lives
10 half-lives
The graphs represent quantal dose–response curves for the effect and lethality of a drug. What is the drug’s therapeutic index?
0.9
1.1
4
10
Which of the following is a common enzyme polymorphism that could potentially alter clopidogrel efficacy?
Cyp2c7
Cyp2c9
Cyp2c10
Cyp2c19
A 55-year-old man comes to the pharmacy complaining that acetaminophen with codeine started 2 days ago to manage post-operative pain does not seem any better than acetaminophen alone. Pharmacogenomics testing performed 3 years ago showed he is a CYP2D6 poor metabolizer. Which is the best explanation why this patient does not seem to benefit from codeine?
Codeine excretion is rapid
Codeine absorption is slower
Codeine is metabolized faster
Which of the following drugs will have decreased absorption when given with dietary calcium?
enalapril
propranolol
doxycycline
acetylsalicylic acid
Which of the following drugs is known to have significant variable bioavailability due to its extensive hepatic metabolism upon oral administration?
Amoxicillin
Propranolol
Ciprofloxacin
Acetaminophen
Which of the following drugs complexes with dairy products or with antacids when administered orally?
Enalapril
Warfarin
Doxycycline
Acetylsalicylic acid
Carbamazepine (pKa = 13.2 ) is an antiepileptic drug used in the treatment of status epilepticus. This condition requires fast intervention with carbamazepine injection. Which of the following is most likely to describe what will happen if carbamazepine was given orally?
Fast intervention because the drug will be ionized in the stomach
Slow intervention because the drug will be ionized in the stomach
Fast intervention because the drug will be unionized in the stomach
Slow intervention because the drug will be unionized in the stomach
A dose of 500 mg of a drug is administered to a patient, and the plasma concentration results at the indicated times are shown. Which of the following is the half-life of the drug?
2 hours
3 hours
4 hours
6 hours
A 500 -mg dose of aspirin was given intravenously to a patient and produced an initial plasma concentration of 100 mg/L. If the half-life of the drug is 6.93 hours, what would be the total body clearance?
50 Liters/hour
10 Liters/hour
5 Liters/hour
0.5 Liters/hour
Which one of the following medications is known to be a powerful enzyme inducer?
warfarin
rifampicin
itraconazole
metronidazole
Which of the following is the mechanism by which phenobarbital can decrease the therapeutic efficacy of tricyclic antidepressants when administered at the same time?
increasing the excretion of tricyclic antidepressants
decreasing the excretion of tricyclic antidepressants
decreasing the metabolism of the drug by induction of microsomal enzymes
increasing the metabolism of the drug by induction of microsomal enzymes
A 50-year-old man on warfarin therapy started drinking an herbal tea (one gallon daily). A week later his INR dropped to 1.35 ; prior to that time, his INR had been in the range of 2.5 – 3 . Once the herbal tea was discontinued, the patient’s INR came back up to 2.50 . Which of the following is the content of the herbal tea extract?
Anise
Ginger
Green tea
Chamomile
Which of the following ranges of volume of distribution is deduced for warfarin (anticoagulant) that is 98% bound to proteins?
3–5 L
40–50 L
50–500 L
5000–10000 L
Elderly patient: what happens with absorption?
Increase both lipophilic and hydrophilic drugs absorption
Decrease both
Increase lipophilic absorption and decrease hydrophilic absorption
Decrease lipophilic absorption and increase hydrophilic absorption
Which of the following has high protein binding?
Lithium
Vancomycin
Phenytoin
Drug should not be used with ciprofloxacin. Which one?
ACEI
atorvastatin
ferrous sulfate
metformin
Drug acid: where will there be high excretion?
pKa 3.3 , weak base
pKa 3.3 , weak acid
pKa 6.8 , weak base
pKa 6.8 , weak acid
Which antifungal binds more to CYP450?
amphotericin
Voriconazole
Note: non-linear kinetics
Drug enhanced its absorption with ranitidine. Which one?
lorazepam
Warfarin
Aspirin
Naproxen
Rifampicin effect on CYP3A4?
Inducer
Inhibition
Which of the following decreases the effect of warfarin?
antibiotics
multivitamins
Which of the following increases the effect of warfarin?
antibiotics
multivitamins
Sodium bicarbonate (antacid) makes an elimination of which ionizable drug?
pKa = 1.2 , weak acid
pKa = 5.1 , weak acid
pKa = 7.8 , weak base
pKa = 9 , weak base
Drug enhanced its absorption with ranitidine. Which one?
lorazepam
Warfarin
Aspirin
Naproxen
What does linear pharmacokinetics mean?
The clearance of the drug is not changing when dose increases
The plasma concentration versus time curve is a straight line
The half-life of the drug is equal to its volume of distribution
The drug levels in the body are in steady state
Which of the following is a characteristic cholesterol?
Cholesterol has hydroxyl group at carbons
Cholesterol is a very hydrophilic compound
Cholesterol has four fused hydrocarbon rings
Cholesterol has three double bonds in its structure
Which of the following best describes the main pharmacological property of cholestyramine?
Decreases excretion of cholesterol
Lowers high-density lipoprotein (HDL) level
Increases low-density lipoprotein (LDL) level
Increase the efficiency of lipoprotein removal
Drugs for dyslipidemia: which causes interaction with multiple chronic disease?
Niacin
Rosuvastatin
Others
Which side effect can be caused by statin therapy?
Fatty liver
New onset diabetes
Gout
Flushing
None of the Above
A 57-year-old man with liver cirrhosis and ascites and a Child-Pugh class score of 8 is having severe pain due to injury. What would be the recommended medication?
Codeine
Morphine
Diclofenac
Acetaminophen
Patient on TPN for 17 days: all liver enzymes are high except albumin is normal; amylase and lipase are normal. What’s the complication of TPN in this patient?
liver stenosis
liver cirrhosis
pancreatitis
cholestasis
Patient with lab results high GGT, high ALT, and high AST; what disease?
Cirrhosis
Hepatic steatosis
Cholestasis
Simvastatin — best time to take it?
In the morning
At bedtime
With lunch
Before exercise
Which of the following drugs is used for premature ejaculation?
Atenolol
Dapoxetine
Olanzapine
Aripiprazole
Which of the following medication is used to treat benign prostatic hyperplasia?
Donepezil
Etanercept
Tamsulosin
Carbidopa
Which of the following medications is an anti-androgen?
Danazol
Tamoxifen
Finasteride
Mifepristone
Which of the following marketing mix contains market cover assortments?
Price
Place
Product
Promotion
What is the main purpose of pharmacy marketing jobs?
Create new jobs
Sell cosmetic products
What is the principle of marketing — options are to:
Gain customers
Satisfaction
Increase sales
A pharmacist wants to increase advertisement for his pharmacy; what is the best questionnaire he can do?
Ask the customers
Online questionnaire
Which of the following marketing mix contains market cover assortments?
Product
Place
Price
Promotion
You have a pharmacy and want to sell it; the buyer asks for sales and profits — what do you give?
Sales records
Net profit
Uniforms
Before marketing Phase 4:
III
IV
V
Price of a product was increased from 100 SA Riyals to 105 SA Riyals, resulting in a decline in demand from 120 to 80. Which type of demand does this product follow?
Elastic
Latent
Inelastic
Unaffected
Which enzyme inhibits bacterial cell wall?
Beta-lactamase
Lysozyme
DNA gyrase
RNA polymerase
Which of the following drugs is found under the narcotic classification?
Fentanyl
Midazolam
Loprazolam
Pentobarbital
Which of the following statements best describes drug dependence?
Discontinuation of the drug will produce withdrawal symptoms
Action of one drug is dependent on the presence of another drug
Discontinuation of the drug will not produce withdrawal symptoms
Patients progressively require larger doses of a drug to achieve the same effect
How long should the control drug be administered by IV route?
12 h
24 h
48 h
What is required in a narcotic prescription option?
More than one narcotic agent can be included in the same prescription
Single narcotic agent written at the top with red pen
The original copy is given to the patient
Drug causes A constipation or B depression or C withdrawal symptoms — select the combination that matches A/B/C.
Morphine/naloxone/pentazocine
Morphine/naltrexone/methadone
Morphine/naloxone/pentazocine
Drug causes A constipation or B depression or C dependence symptoms — select the combination that matches A/B/C.
Morphine/naltrexone/pentazocine
Morphine/naloxone/methadone
Morphine/naloxone/pentazocine
Which decreases the minimum alveolar concentration for anesthetic drugs?
Diazepam
Norepinephrine
Ketamine
Nitrous oxide
A patient takes oral morphine 90 mg daily and wants to replace it with a transdermal fentanyl patch. What patch strength should be used?
30 mcg/h
15 mcg/h
25 mcg/h
10 mcg/h
A patient uses morphine 50 mg twice daily and wants to change to a transdermal fentanyl patch. What patch strength should be used?
25 mcg/h
50 mcg/h
100 mcg/h
A 23-year-old drug addict man presents with severe agitation and excitement. He was administered intravenous diazepam with no improvement. Which of the following is the most likely drug he was addicted to?
Opioids
Cocaine
Pregabalin
Cannabinoids
A 10-year-old boy has fever, sore throat, and non-productive cough for 1 day. Which regimen is best for non-productive cough?
Codeine 10 mg four times daily
Guaifenesin 50 mg four times daily
Dextromethorphan 15 mg twice daily
Dextromethorphan 30 mg twice daily
Patient with runny nose needs fast relief of congestion; which option is best?
Pheniramine
Pseudoephedrine
Intranasal cromolyn
Corticosteroid
Which of the following drugs has a high abuse potential?
Nifedipine
Allopurinol
Varenicline
Methylphenidate
How to measure pain in a child?
Numerical Rating Scales (NRS)
Verbal Rating Scales (VRS)
Visual Analog Scales (VAS)
Faces Pain Scale–Revised
Which of the following drugs has both anti-inflammatory and analgesic activity?
Codeine
Pethidine
Ibuprofen
Paracetamol
A 4-week infant is diagnosed with patent ductus arteriosus. The doctor wants to avoid performing surgery. Which drug will be administered to avoid surgical closure?
Allopurinol
Indomethacin
Pseudoephedrine
Brompheniramine
Which instruction should be provided to a patient receiving fentanyl transdermal patches?
Apply on an area with a fresh wound
Avoid increase in body core temperature
Store patches in the refrigerator to decrease stinging sensation
Apply heating pads on the transdermal patch to improve absorption
A 60-year-old man with history of myocardial infarction and gout presents with acute flare-associated pain and cannot take colchicine. What is the most appropriate pharmacotherapy recommendation?
Ibuprofen
Allopurinol
Indomethacin
Acetaminophen
An 88-year-old frail woman with osteoarthritis has difficulty walking and pain and has failed numerous aids. She has no other medical history. Which drug is the best recommendation?
Acetaminophen
Glucosamine
Celecoxib
Ibuprofen
A 65-year-old woman with osteoarthritis is prescribed naproxen 500 mg twice daily. Which adverse effect is seen with long-term use of naproxen?
Cirrhosis
Renal failure
Hypotension
Irritable bowel syndrome
Which NSAID has the longest duration of action?
Piroxicam
Ibuprofen
Naproxen
Diclofenac
A 28-year-old woman who is 8 months pregnant has been taking naproxen 500 mg twice daily for 4 weeks to treat severe backache. Which health issue at the time of birth puts the neonate at higher risk?
Asthma
Cardiac arrhythmias
Uncontrolled bleeding
Gastroesophageal reflux disease
Which of the following drugs has both anti-inflammatory and analgesic activity?
Codeine
Pethidine
Ibuprofen
Paracetamol
Which of the following is the mechanism of action of anti-inflammatory action of aspirin?
Inhibition of nitric oxide synthesis
Reduction in leukotrienes formation
Increased synthesis of prostaglandins
Decreased synthesis of prostaglandins
Aspirin is dispensed to an infant as antipyretic, which of the following we should ask before dispensing the medication?
weight
Age
Hight
Head circumference
Patient has osteoarthritis in knee?
paracetamol
gabtin
glucosamine
Which of the following antigout medications acts by decreasing serum levels but increasing urine levels of uric acid, thus increasing the risk of kidney stone development?
colchicine
allopurinol
probenecid
rasburicase
pegloticase
What is the ibuprofen and aspirin drug–drug interaction?
Increase Bleeding
Increase Blood Pressure
Decrease Blood Pressure
Increase Risk Of Myopathy
Plant Alkaloid uses in acute gout attack?
Naproxen
Colchicine
Allopurinol
Indomethacin
Xanthine oxidase inhibitors uses in gout?
Allopurinol
Sulindac
Naproxen
Indomethacin
Elderly renal pt?
Ibuprofen
Sulindac (May Cause kidney Dysfunction In Elderly)
indomethacin
codiane+paracetamol
NSAIDs low git risk?
DICLOPHENAC
Celecoxib
Drug not use in gout patient?
Enalapril
diuretic
Which of the following is the most appropriate advice to give to asthmatic patients as non-pharmacological management?
Air purifiers will help ease the patients’ symptoms
OB Weight-loss is unlikely to affect their symptoms now
Patients should be trained on breathing exercise programs
OD.increase physical activity
Which of the following counselling points is best to discuss with a patient who is taking levothyroxine?
It can be taken with calcium supplements or dietary foods with no problems
Take it in the morning on an empty stomach, at least 60 mins (before breakfast)
If you miss a dose, make sure to double the next scheduled levothyroxine dose
Take it immediately after the breakfast with a large glass of water to avoid stomach upset
Which of the following is considered intentional non-adherence?
Patient unable to swallow
Confusion
Forgets
Afraid of side effects
Drug used after trial in hospital?
internal validity
external validity
reliability
Which of the following have means that individuals have the capacity to understand basic health information to make appropriate health decisions?
Health literacy
Cultural competency
Communication skills
Professional communication
Which of the following communication techniques is the most appropriate that the message you want to deliver to a patient (or healthcare provider) is received correctly?
Feedback
Direct contact
High voice tone
Non-verbal communication
Which of the following strategies are used with low literacy patients to encourage them to change their behavior?
Keep information focused and organized
Use a normal speaking tone and volume
Use briefer educational sessions
Use more visual aids
Which of the following strategies are used with older adult patients to encourage them to change their behavior?
Use teach-back more often throughout the session
Introduce new concepts more slowly
Use briefer educational sessions
Use more visual aids
Which one of the following question's types is used to identify a certain piece of information?
Leading questions
Open ended questions
Closed ended questions
Process and outcome questions
Which one of the following questioning techniques uses hints and aid patients in answering questions?
Changing questions
Empathic responding
Prompting while asking
Redirection the questions
A 62-year-old man who just had a needle biopsy of pancreas adenocarcinoma. A pharmacist saw his brother in the hall, and him not to tell the patient because the knowledge would be very on his health. A family conference to discuss the prognosis is scheduled for later that afternoon. What is the way for the healthcare practitioner to handle the situation?
The healthcare practitioner should ask the patient how he information in front of the rest of the family, and for some family discussion time for this matter
The healthcare practitioner should honor the request of the member who is protecting his beloved brother from the patient
The healthcare practitioner should tell the patient withholding information is not permitted under any circum
The patient should withhold informing the patient about the 2 pancreatic cancer because of the grave diagnosis
Which of the following communication skills can help patient complete their train of thought?
Closed-ended questions
Facial expression
Use of reminders
Body posture
