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A patient with acute pharyngitis caused by group A Streptococcus (strep throat) is allergic to penicillins (non- immediate type), which of the following is NOT recommended as treatment?

AClindamycin

BAmoxicillin

CCefalexin

DClarithromycin

Question 2

Which of the following statements is true regarding Drug-receptor bonds?

ACovalent bonds of drugs with receptors are strong and mostly reversible

BCovalent bonding is much more common than electrostatic bonding in drug-receptor interactions

CElectrostatic bonds are stronger than covalent bonds

DHydrophobic bonds are weak bonds and they are important in the interactions of highly water soluble drugs with the lipids of cell membranes

EBond formation of between the acetyl group of aspirin and cyclo-oxygenase enzyme is a covalent bond

Question 3

LT is a 42-year-old white female with past medical history of epilepsy, gastroesophageal reflux disease and seasonal allergies. She weighs 86 kg, height 5'6'' and allergic to Aspirin (rash) and Phenobarbital (difficulty breathing).

Her medications include Omeprazole 40mg daily, Phenytoin 200mg twice daily, Valproic acid 500mg four times daily, Loratadine 10mg daily. She comes to your community pharmacy to pick up prescription for Primidone 250mg twice daily.

Pertaining to Primidone what is the most appropriate action to take?

ANotify the physician, Primidone dose is too low.

BNotify the physician, Primidone in contraindicated in patient with phenobarbital allergy.

CNotify the physician, Primidone in contraindicated in patient with Aspirin allergy.

DNotify the physician, patient is already on three anti-seizure medication and primidone is not needed.

ENotify the physician, Primidone in contraindicated in patient with gastroesophageal reflux disease.

Question 4

Which of the following side effects should LT be made aware of while on Divalproex Sodium?

AWeight gain

BOligomenorrhea

CAlopecia

DGynecomastia

EGingival hyperplasia

Question 5

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS

with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L. Day 3 post-operation LN's pain was much better and only used 3 mg of hydromorphone in the 24hrs.

Physician wants to change to oral morphine. What would be your best recommendation?

AMorphine SR 10mg po daily and morphine 5mg po q6h prn for breakthrough pain

BMorphine 60mg ER po daily and morphine 15mg po q6h prn breakthrough pain

CMorphine 30mg ER po q6hr and morphine 5mg q6h prn for breakthrough pain

DMorphine 15mg ER po q12hr and morphine 15mg po q6h prn for breakthrough pain

EMorphine 15mg ER po q12hr and morphine 5mg po q6h prn breakthrough pain
Section: (none)
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