Module 3: RATIONALIZATION

Practice of Pharmacy(Clinical Pharmacy, Hospital Pharmacy,

Dispensing, Incompatibilities, ADR, Pharmaceutical Calculations)

1. It refers to the responsible provision of drug therapy to achieve definite outcomes that are intended to improve a patient’s quality of life:

a. Drug therapy assessmentb.Therapeutic drug monitoringc. Pharmaceutical cared.Professional-patient relationshipe.Formal documentation

Components of Pharmaceutical care:• Equal responsibility (to patient and prescriber)• Professional-patient relationship• Formal documentation ( clinical interventions and

therapeutic outcomes )

2. A way of summarizing the health benefits and resources used by competing health care programs so that policy makers can choose among them:

a. Cost-of-Illness Evaluationb.Cost-Minimization Analysisc. Cost-Utility Analysisd.Cost-Effectiveness Analysise.Cost-Benefit Analysis

3. Any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis or therapy:

a. Allergyb.Adverse drug reactionc. Adverse drug eventd.Hypersensitivitye. idiosyncracy

-adverse drug event is used to describe an injury resulting from administration of drug

4. Patient R.S. had bone marrow transplant 5 years ago. This information belong in which section of the patient’s medical chart:

• ROS – Review of Systems• FH – Family History• HPI – History of Present Illness• PMH – Past Medical History• PMP – Patient Medication Profile

5. Which of the following insulins exert the longest duration of action

a. Humalog – Insulin Lisprob.Lantus – Insulin Glarginec. Humulin R – regular Insulind.Novo rapid – Insulin Asparte. Insulin NPH

Insulin Duration of ActionA. Short-acting1. Insulin Lispro 3-5 h2. Insulin Aspart 3-5 h3. Regular 5-8 hB. Intermediate-acting1. NPH >14 hC. Long-acting1. Glargine 24 h2. Detemir 6-23 hD. Pre mixed1. Lispro mix 75/25 14-24 h2. Aspart mix 70/30 18-24 h

6. Which of the following is not an objective parameter:

a. Bilirubinb.Creatininec. Urine outputd.Vertigoe.CBG – Capillary Blood Glucose

7. When blood urea nitrogen (BUN) is above the normal values, it indicates the following conditions except:

a. Dehydrationb. GI bleedingc. Liver diseased. Renal disease

-BUN is the measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function. Urea is a by- product from metabolism of proteins by the liver, and therefore removed from the blood by the kidneys.

8. The clinical pharmacist functions focus on the:

a. Productb.Hospitalc. Diagnosisd.Patiente. Income

9. Which of the following provides the greatest number of calories per gram:

a. Dextroseb.Proteinsc. Fatsd.Ethanol

Fat: 1 gram = 9 calories Protein: 1 gram = 4 calories Carbohydrates: 1 gram = 4 caloriesAlcohol: 1 gram = 7 calories

10. Exforge ® is an anti hypertensive agent which is a combination of:

a. Amlodipine & valsartanb.Telmisartan & HCTZc. Valsartan & HCTZd.Enalapril & amlodipine

11. Which of the following dosages of dopamine is selected for its positive inotropic effects in treating the patient with Heart Failure:

a. 40 mg/kg/minb.40 ug/kg/minc. 10-20 ug/kg/mind.5-10 ug/kg/mine.2 ug/kg/min

12. Measures the electrical activity of the brain, and helps to identify functional cerebral changes underlying structural abnormalities:

a. CBG – Capillary Blood Glucoseb.EEG – Electroencephalogramc. MRI – Magnetic Resonance Imagingd.PET – Positron Emitting Tomographye.CSF – Cerebro Spinal Fluid- EEG serves as diagnostic tool in classifying

seizures.

13. Agent/s that inhibit smooth muscle contractions in asthmatic patients is/are:

I. Beta adrenergic agonistsII. MethylxanthinesIII. GlucocorticoidsIV. Anticholinergics

a. I and IVb.I, II and IVc. II, III and IVd.AOTAe.I,II and III

Drugs that inhibit smooth muscle contraction are often called “quick relief medications” ex. Beta adrenergic agonists, methylxanthines, anticholinergics

Glucocorticoids are considered “long term control medications”

14. It is a rapid-acting insulin preparation:a. Humalog – Insulin Lisprob.Lantus – Insulin Glarginec. Levemir – Insulin Detemird.Humulin N – Insulin NPHe.Insulin NPH

Insulin Onset of ActionA. Short-acting1. Insulin Lispro Within 15 mins2. Insulin Aspart Within 15 mins3. Regular 30 – 60 minsB. Intermediate-acting1. NPH 2.5 – 3 hC. Long-acting1. Glargine 1.5 h2. Detemir 3.4 hD. Pre mixed1. Lispro mix 75/25 0.25 – 5 h2. Aspart mix 70/30 0.1 – 0.2 h

15. It is the hypermetabolic syndrome that occurs from excessive production of thyroid hormone with classic symptoms of weight loss despite increases appetite, nervousness, palpitations, heat tolerance and insomnia:

a. Thyrotoxicosis or “Hyperthyroidism”b.Hypothyroidismc. Graves disease – autoimmune disorder causing hyperthyroidism.

d.Cushing syndromee.Hashimoto’s disease

16. Which of the following types of questions should be avoided while interviewing the patient:

a. Leading questionsb.Multiple questionsc. Excessive yes/no questionsd.AOTAe.NOTA

17. The following are clinical functions of pharmacists except:

a. Prepare medicationsb.Taking inventoriesc. Participate in patient education programd.Assess drug interactions and ADRs

18. In hospital abbreviations, Pt. means:

a. Prothrombin Timeb.ProTimec. Patientd.Pint

19. Tx means:

a. Treatmentb.Therapeuticc. Therapeuticsd.Therapy

20. Patient N.H. has a BMI of 27kg/m2, patient N.H. is considered to be:

a. Underweightb. Normal weightc. Overweightd. Obese -BMI = weight in kg / (Height in meters)2

Interpretation: Underweight < 18.5Normal weight = 18.5 - 24.9Overweight = 25.0 - 29.9Obese > 30.0

21. The successor of the first hospital pharmacist that revolutionize the practice of pharmacy and medicine in the hospital setting:

a. Jonathan Robertsb.John Morganc. Jason Bourned.Jonathan Morgan

22. First hospital pharmacy practice was observed in which hospital?

a. Pennsylvaniab.Plymouthc. San Antonio d.Washington

23. The first hospital pharmacist:

a. Jonathan Robertsb.John Morganc. Jason Bourne d.Jonathan Morgan

24. A form of therapy offered as a substitute for drug therapy that follows the biochemical effects derived from essential oils:

a. Acupunctureb.Aromatherapy c. Massage d.Chiropratic medicine

25. Patients who can walk and not bedridden:

a. Institutionalizedb.Inpatientc. Ambulatory d.Outpatient

26. A facility where patients who are not confined are treated by a set of physician practicing together:

a. Hospitalb.In-house facilityc. ERd.Clinic

27. Which is not a fundamental function of a hospital?

a. Researchb.Wellnessc. Educationd.NOTA

28. ASHP stand for:

a. American Society of Hospital Pharmacistb.American Society for Hospital Practitionersc. Asian Society of Hospital Pharmacistd.American Society of Health-system

Pharmacists

- New meaning of ASHP

29. Hospitals function in assisting their communities the incidence of illness and improve quality of life, is under what fundamental function?

a. Researchb.Educationc. Patient Care d.Wellness

30. The Hospital Pharmacist holds what position in the P&T Committee?

a. Chairb.Secretaryc. Treasurer d.NOTA

31. The degradation reaction of ASA involves:

a. hydrolysisb.racemizationc. oxidationd.photolysise.Reduction- in presence of moisture or water, ASA will

hydrolyze into acetic acid and salicylic acid.

32. The most serious drug-induced blood disorder:a. aplastic anemiab. leukemiac. agranulocytosisd.Thrombocytopenia

- This is also referred to as pancytopenia resulting from damaged pluripotent stem cells.

- It is characterized by acellular or hypocellular bone marrow

33. Which is NOT true for camphor? I. forms a eutectic mixture with mentholII. can be powdered by rubbing with a small amount of alcohol

or etherIII. dissolves readily in water

a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II, and III

-Camphor is soluble in alcohol and organic solvents but is only slightly soluble in water (1g in 800 ml)

34. Which one of the following diluents is LEAST suitable for reconstituting single-dose vials?

a. Bacteriostatic Sterile Water for Injection (BSWFI)

b.D5W injection

c. N/S injectiond.0.5 N/S injectione.Sterile Water for Injection (SWFI)

BSWFI should not be used for reconstituting single-dose units because the preservative present would serve no useful purpose, and large amounts of the preservative could increase the incidence or severity of toxicity.

The use of BSWFI may be appropriate if a powder in a multidose vial is being reconstituted.

35. Methysalicylate is also known as: a. camphorated oilb.peppermint oilc. salicylamided.oil of wintergreene.sweet oil

-Methyl salicylate can be used in small quantities as flavoring or perfuming agent. -It is also included in many topical products such as rubbing alcohol, gels and liniments

36. Alcohol is suitable as a solvent for menthol and salicylic acid when preparing which of the following dosage forms? I. lotionsII. ointmentsIII. Suppositories

a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II, and III

37. The ideal weight for a vaginal suppository will be approximately:

a. 1 g b.2 g c. 5 gd.10 ge.15 g

- rectal suppositories: 2 grams

38. The most practical method for sterilizing the ophthalmic solution is:

a. autoclaving for 15 minutesb.autoclaving for 30 minutesc. membrane filtration through 0.2-micron filterd.membrane filtration through 5-micron filtere.use of ethylene oxide gas

- Membrane filtration involves the passing of solutions through a 0.2 micron filter using one of the commercially available sterile filter units such as Millipore's Millex or Swinnex units.

39. Boric acid is present in the formula as a (an) :I. antioxidantII. antimicrobial preservativeIII. buffering agent

a. I onlyb.III onlyc. I and II onlyd.II and III onlye. I, II, and III

40. Ondansetron is available under the trade name of :

a. Kytril - Granisetronb. Marinol - Dronabinolc. Reglan - Metoclopramided. Zofrane. Zoloft – Sertraline (Antidepressant) -all except Zoloft are used for nausea and vomiting

during chemotherapy

41-42. 41. How many mg of codeine base is in each dose of the cough product? (mol.

wt.: codeine = 299; codeine phosphate = 406)a. 6 mgb. 8 mgc. 11 mgd. 16 mge. 24 mg

42. How many mg of codeine phosphate are being consumed daily by a patient taking the prescription as directed?

a. 6.25 mgb. 8.25 mgc. 19 mgd. 25 mge. 33 mg

(E) Because the volume of a standard teaspoon is considered to be 5 mL, the patient in this prescription is receiving four daily doses for a total of 20 mL.

43. A hospital pharmacy technician has written the following formula for inclusion into the master manufacturing formula book.

Codeine sulfate 0.5 grAspirin 1.6 grHydrocortisone 120 mgLactose qs 6 grams

Mix and make 30 capsules

(cont..) When reviewing this formula, the pharmacist should comment upon which of the following expressions?I. 0.5II.grIII. qs

a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II, and III

44. Alcohol has many pharmaceutical uses and is available in several concentrations. What is the concentration (% v/v) of diluted alcohol?

a. 49%b.70%c. 92%d.95%e.100%

45. How many grams of glacial acetic acid (99.9% w/w) must be added to 1 gal purified water to prepare an irrigation solution containing 0.25% wt./vol. acetic acid?

a. 1.2 gb.9.5 gc. 12 gd.20 ge.95 g

One gallon contains 3,785 mL; thus 3,785 mL × 0.25% = 9.46 or 9.5 g. Because the volume contributed by the acetic acid is insignificant when compared to 3,785 mL, it does not enter into the calculation of the final volume.

46. A nurse adds a 4-mL Tubex unit containing 2.4 M units penicillin suspension to a 20-mL vial containing 10 mL of normal saline. What is the new concentration of penicillin expressed as units/mL?

a. 170b.240c. 170,000d.240,000e.600,000

2.4 megaunits is 2.4 million units or a total of 2,400,000 units. The final dilution will have a volume of 14 mL.

units/mL. 170,000or units/mL 400,171mL 14

2,400,000

47. A hospital pharmacy needs 1 qt of an antibacterial solution containing 92% v/v alcohol. How many mL of alcohol USP will be needed?

a. 458 mLb.870 mLc. 916 mLd.920 mLe.968 mL

[Q1][C1]= [Q2[C2][x mL][95% vol./vol.]= [946 mL][92% vol./vol.]

95x = 92,000x = 916 mL

48. How much sodium chloride is needed to adjust the following prescription to isotonicity? (E value for sodium thiosulfate is 0.31.)

a. 0.37 gb. 0.45 gc. 0.53 gd. 0.31 ge. 0.90 g

RxSodium thiosulfate 1.2%Sodium chloride qsPurified water qs 100 mL

Step 1—Determine amount of sodium thiosulfate in the Rx:100 mL × 1.2% = 1.2 g or 1,200 mg

Step 2—Multiply the amount of chemical by its “E” value:1,200 mg × 0.31 = 372 mg (equivalent amount of

NaCl)Step 3—Determine amount of NaCl needed as if no other chemical was present:

100 mL × 0.9% = 900 mgStep 4—Subtract contribution by chemical (Step 2) from amount of NaCl (Step 3):

900 mg – 372 mg = 528 mg = 0.53g(The amount of NaCl needed to render the solution isotonic.)

49. How many grams of pure hydrocortisone powder must be mixed with 60 g of 0.5% hydrocortisone cream if one wishes to prepare a 2.0% w/w preparation?

a. 0.90 gb.0.92 gc. 0.30 gd.1.2 ge.1.53 g

Because the amount of 0.5% hydrocortisone cream is exactly 60 g, the final weight of the cream will be greater when hydrocortisone powder is added. Therefore, the problem may be solved by the allegation alternate method or by simple algebra:

100% HC

1.5 parts

2%

0.5% HC 98 parts

OR....

by algebra, let x = weight of 100% HC powder, then(x g) (100%) + (60 g) (0.5%)= (60 g + x g) (2%)

x + 0.3 = 1.2 + 0.02 xx = 0.92 g

50. A pharmacist adds 2 g of potassium chloride to 1 L of D5W/1/2 normal saline. Estimate the osmolarity (mOsm/L) of this solution assuming the final volume is 1 L. (Atomic wt.: sodium = 23, potassium = 39, chloride = 35.5, dextrose = 198.)

a. 54 mOsm/Lb.300 mOsm/Lc. 405 mOsm/Ld.460 mOsm/Le.477 mOsm/L

Three chemicals are contributing to the osmolarity.Potassium chloride

2 g ÷ 74.5 = 0.0268 mol or 26.8 mM26.8 mM × i value of 2 = 53.6 mOsm

Dextrose 50 g ÷ 198 = 0.253 mol or 253 mM253 mM × i value of 1 = 253 mOsm

Sodium chloride 1,000 mL 0.45% = 4.5 g

4.5 g ÷ 58.5 = 0.0769 mol or 76.9 mM76.9 mM × i value of 2 = 153.8 mOsm

Total in 1 L = 53.6 + 253 + 153.8 = 460 mOsm/L

51. Primary function of P&T Committee:

a. Policy Developmentb.Educationc. AOTAd.NOTA

52. A type of drug distribution system that makes medication available at nursing units of hospitals and for which a charge is made to the patient.

a. Charged Floor Stockb.Free Floor Stockc. Unit Dose Delivery d.Complete Floor Stock

53. Focus of all Physician-Pharmacist-Nurse interactions:

a. Hospitalb.Policy Implementationc. Patient d.AOTA

54. Function of P&T Committee, except:

a. Disseminate information on its action to all healthcare staff

b.Establish program for safe and efficient drug usage

c. Develop a formulary of drugd.AOTAe.NOTA

55. ABG stands for:

a. Arterial blood gradientb.Arterial Blood gassesc. C. Abdominal Bend Gauge d.Acid-Base Gap

56. D &C stands for:

a. Discontinueb.Dye and Colorc. Dilatation and Curettaged.AOTA

57. HOPI stands for:

a. History of Present Illnessb.History of Past Illnessc. History of Patient Illness d.AOTA

58. Drugs with indicated use together with a “p.c” note should be taken when?

a. After mealb.Before mealc. Before sleepingd.After waking-up

59. A type of hospital where all professional services, private and charity are provided and controlled by the active medical staff:

a. Closed Staffb.Open Staffc. Honorary Medical Staff d.Consulting Staff

60. A private or public organization that provides comprehensive healthcare services to individuals enrolled to the organization:

a. Hospitalb.Health Management Organizationc. Health Maintenance Organization d.Health Care Organization

61. 5%D/LR means:

a. 5% Dextrose or Lactated Ringers b.5% Dextrose and Lactated Ringersc. 5% Dextrose in Lactated Ringers d.NOTA

62. PICU stand for what hospital department?

a. Pulmonary Intensive Care Unitb.Patient Information and Concern Unitc. Patient Information and Care Unitd.NOTA

63. Which hospital in the Philippines is the second hospital in Asia to be accredited by JCIA, and is considered as a tertiary hospital with a 650 bed capacity:

a. UST Hospitalb.St. Luke’s Medical Centerc. Manila Doctor’s General Hospital d.Philippine General Hospital

64. A type of hospital that provides specific services to specific and selected type of patient or cases:

a. General Hospitalb.Special Hospitalc. BOTHd.NOTA

65. Hospital Pharmacy was said to evolve from the early practice dated back in the times of Hippocrates. Where did Hippocrates practice Medicine and Pharmacy?

a. Temple of Kasb.Temple of Krosc. Temple of Kosd.Temple of Kratos

66. When preparing a liquid dosage form, elixirs may be preferred over syrups because elixirs have better solvent properties for:I. weak organic acidsII. weak organic basesIII. flavoring oils

a. I onlyb. III onlyc. I and II onlyd. II and III onlye. I, II, and III

-Elixirs are clear, sweetened, usually flavored hydroalcoholic solutions intended for oral use

67. The process of wetting and smoothing zinc oxide with mineral oil in preparation for incorporation into an ointment base is:

a. attritionb.levigationc. millingd.pulverizatione.trituration

68. Before placing a patient on IV fatty oil emulsions, the clinical pharmacist should confirm that the patient does NOT have:

a. egg allergiesb.sensitivities to bisulfitec. milk intoleranced.lactose intolerancee.sensitivities to tartrazine

- Fatty oil emulsions are stabilized by the presence of egg phospholipids. As such they are usually contraindicated in those patients with serious allergies to eggs.

69. The incompatibility between __________ is a potential problem

a. potassium chloride and calcium gluconateb.potassium chloride and insulinc. potassium phosphate and calcium gluconated.potassium phosphate and zinc chloridee. insulin and zinc chloride

70. Which of the following antacid cannot be used by patients with heart failure?

a. sodium bicarbonateb.Aluminum hydroxidec. calcium carbonated.magnesium hydroxide

-This cannot be used because of sodium content

71. Potential adverse effects of Aspirin include: I. GI ulcerationII. hypersensitivity asthmaIII. cardiac arrhythmias

a. I onlyb.II onlyc. I and IId.II and IIIe. I, II, and III

- Cardiac arrhythmia is not induced by ASA

72. Which of the chemotherapeutic agents is most likely associated with pulmonary toxicity?

a. Vincristineb.Doxurubicinc. Paclitaxeld.Bleomycin

73. Which of the following mood stabilizers would be most appropriate in a patient with liver disease?

a. Lithiumb.Valproic acidc. carbamazepined.AOTA

- Lithium is not known to cause hepatic dysfunction nor is metabolized via the liver. However both valproic acid and carbamazepine can impair liver function

74. Levodopa is associated with which of the following problems?

a. GI disturbancesb.Postural hypotensionc. Dystoniad.Depressione.AOTA

-Adverse effects of levodopa include GI disturbances, cardiovascular, musculoskeletal, CNS and haematological effects

75. This anti-parkinsonian agent may cause a first dose phenomenon that can trigger sudden cardiovascular collapse:

a. Bromocriptineb.Selegilinec. Pergolided.Amantadinee.NOTA

- Bromocriptine should be used with caution in patients with a history of MI and arrhythmias

76. Substances which absorb moisture from the air but do not dissolve are called:

a. hygroscopic powdersb.effervescent powdersc. deliquescent powdersd.anhydrous powderse.efflorescent powders

77. This contains the conditions to which the use of the product is known to be associated to an unacceptable risk:

a. warningb.precautionc. contraindicationd.indicatione.NOTA

78. These medications decrease the levels of phenytoin, carbamazepine, Phenobarbital, and primidoneby enhancing their metabolism:

a. oral contraceptivesb.oral hypoglycemicsc. glucocorticoidsd.TCAse.AOTA

-Other drugs that have same effect are azathioprine, cyclosporine, quinidine, theophylline, warfarin, doxycycline, and levodopa

79. Characterizes the first exposure of the fraction of the drug metabolized in the liver:

a. first pass effectb.drug-receptor interactionc. biotransformationd.pharmacokineticse.clearance

80. Aminophylline is indicated for bronchial asthma and for reversible bronchospasm associated with chronic bronchitis and emphysema. It is approximately 80 % theophylline. Which of the following can cause precipitation of theophylline from aminophylline solution?

a. HClb. NaOHc. NaCld. Watere. Na2SO4

-Aqueos solutions are alkaline and display the incompatibilities of the alkalies. Acid cause a precipitation of theophylline.

81. A patient’s serum cholesterol value is reported as 4 mM/L. What is this concentration expressed in terms of mg/dL? (mol. wt. of cholesterol = 386)

a. 0.154 mg/dLb.1.54 mg/dLc. 154 mg/dLd.596 mg/dLe.1,540 mg/dL

In this problem, the mM/L concentration is converted by recognizing that 1 mol of cholesterol weighs 386 g and 4 mmol equals 0.004 mol.

386 x 0.004 mol = 1.544 g or 1,540 mg/L1,540 mg/L = 154 mg/dL

82. The adult dose of a drug is 250 mg. What would be the approximate dose for a 6-year-old child weighing 60 lb? (Use Young’s rule.)

a. 60 mgb.85 mgc. 100 mgd.125 mge.180 mg

83. A physician requests 1 av.lb of bacitracin ointment containing 200 U of bacitracin per gram. How many grams of bacitracin ointment (500 U/g) must be used to make this ointment?

a. 182 gb. 200 gc. 227 gd. 362 ge. 400 g

84. Calcium chloride (CaCl2·2H2O) has a formula weight of 147. What weight of the chemical is needed to obtain 40 mEq of calcium? (Ca = 40.1; Cl = 35.5; H2O = 18)

a. 0.80 gb.1.47 gc. 2.22 gd.2.94 ge.5.88 g

One equivalent of calcium chloride = 147 (mol. wt.) divided by 2 (valence of calcium) = 73.5 g and 1 mEq = 73.5 mg. Therefore, 40 mEq is 40 × 73.5 mg = 2,940 mg, which is 2.94 g. Or, the problem can be solved by the following equation:

85. A 250-mL infusion container contains 5.86 g of potassium chloride (KCl). How many milliequivalents (mEq) of KCl are present? (mol. wt. of KCl = 74.6)

a. 12.7 mEqb.20 mEqc. 78.5 mEqd.150 mEqe.157 mEq

86. The hospital protocol calls for additional dosing when the trough level of tobramycin (mol. wt. = 470) approaches 2 g/mL. The concentration may also be expressed as how many mol/L?

a. 2.1b.4.2c. 6.4d.8.5e.0.04

87. -8987. What flow rate must be programmed into the PCA unit to obtain the

desired amount of morphine per minute?a. 0.01 mL/minb. 0.05 mL/minc. 0.1 mL/mind. 0.1 mL/he. 1.0 mL/min

88. Upon consultation, the prescriber decides to allow bolus PRN dosing of 2 mg with a lockout of 1-h intervals. Assuming that the patient uses all bolus-dosing intervals, approximately how long will the PCA last?

a. <2.5 daysb. 4 daysc. 7 daysd. 10 dayse. >14 days

The maximum volume used per hour will be 0.01 mL/min 60 min = 0.6 mL plus bolus dosing of 2 mg (0.4 mL) = 1 mL total. Since the total volume in the PCA is 100 mL, it should last at least 100 h or 4.2 days.

89. How many mL of a commercial morphine sulfate vial (25 mg/mL) is needed to fill this order?

a. 10 mLb. 20 mLc. 25 mLd. 30 mLe. 50 mL

90. Alcohol has many pharmaceutical uses and is available in several concentrations. What is the concentration (% v/v) of full strength alcohol?

a. 49%b.70%c. 92%d.95%e.100

Alcohol USP, sometimes known as grain alcohol, contains 94.9% v/v or 92.3% w/w of C2H5OH. The remaining portion is water. It may be used as a solvent and as a source of alcohol for oral dosage forms.

91. A prescription calls for the dispensing of a 4% Pilocar solution with the directions of “gtt i OU TID.” How many mg of pilocarpine hydrochloride is being used per day? Assume that the dropper is calibrated to deliver 20 drops to the mL.

a. 4 mgb.6 mgc. 12 mgd.24 mge.60 mg

92. A nurse in a nursing home setting mixes 240 mL of a dietary supplement formula (400 mOsm/L) with 250 mL of D10W and 200 mL of water containing 5 g calcium chloride (mol. wt. = 111; mol. wt. of dextrose = 180). What is the osmolarity of this solution?

a. 280 mOsm/Lb.370 mOsm/Lc. 410 mOsm/Ld.470 mOsm/Le.540 mOsm/L

93. How many mg of sodium chloride should be added to the following medication order to maintain isotonicity? “Atrovent Inhalation Solution 0.02% 5 mL + SWF Injection 25 mL. Place in nebulizer ut dict” (Note: Atrovent inhalation solution is isotonic.)

a. 45 mgb. 225 mgc. 270 mgd. 900 mge. 0 (since sterile water for injection is already

isotonic)

Since the 5 mL of Atrovent inhalation solution is already isotonic, the pharmacist has to render the remaining volume of solution (diluent) isotonic.

30 mL – 5 mL= 25 mL25 mL × 0.9% sodium chloride= 225 mg

94. A hospital clinic requests 2 lb of 2% hydrocortisone ointment. How many grams of 5% hydrocortisone ointment should be diluted with white petrolatum to prepare this order?

a. 18.2 gb.27.5 gc. 45.4 gd.363 ge.545 g

95. How many mL of isopropyl rubbing alcohol (70% v/v) will be needed to prepare 1 pt of 50% isopropyl alcohol?

a. 70 mLb.170 mLc. 342 mLd.400 mLe.480 mL

96. Tuberculin syringe can measure up to:

a. 1 mLb. 5 mLc. 10 mLd. 20 mL

97. Drug of Choice for Status Epilepticus:a. Lamotrigineb.Phenobarbitalc. Diazepamd.Ethosuximidee.Carbamazepine

-1st line of treatment, Diazepam 0.2-0.3mg/kg/dose then may repeat up to 3 doses until seizure stops

98. All are criteria for classification of Systemic Lupus Erythematosus (SLE), except:

a. Malar rashb.Neurologic disorderc. Arthritisd.GI ulcerationse.Oral ulcers

Criteria: MnemonicS - erositisO -ral ulcerA- rthritisP- hotosensitivity

B-lood disorderR- enal disorderA- ntinuclear AntibodiesI- mmunologic disorderN- eurologic disorder

M-alar rashD-iscoid rash

99. It is a genetically determined abnormal response to ordinary doses of a drug:

a. Anaphylaxisb.Idiosyncracyc. Sensitizationd.Drug Interaction

100. Vascor® is an anti hypertensive medication classified as:

a. ACEIs – “prils”b. ARBs – “sartans”c. CCB – “dipines” ,verapamil,diltiazemd. Beta blockers – “olols”

-Vascor is imidaPRIL