What is the principal advantage of Olinvyk, a newly approved opioid pain reliever, over available other opioid analgesics?

a. Cheap
b. Less chance of abuse
c. no dosage adjustments in patients with renal impairment
d. does not cause fatal respiratory depression
e. more patient compliance due to its oral dosage form

  Answer  

What is the principal advantage of Olinvyk, a newly approved opioid pain reliever, over available other opioid analgesics?

a. Cheap
b. Less chance of abuse
c. no dosage adjustments in patients with renal impairment
d. does not cause fatal respiratory depression
e. more patient compliance due to its oral dosage form

Answer: (c). Olinvyk is an opioid agonist that is the first new chemical entity in this IV drug class in decades and offers a differentiated profile that addresses a significant unmet need in the acute pain management landscape. Olinvyk delivers IV opioid efficacy with a rapid 2-5 minute onset of action. In addition, Olinvyk requires no dosage adjustments in patients with renal impairment, a large patient population with significant medical complications.

"Complex patients present unique challenges in the management of their postoperative acute pain, due to the presence of medical comorbidities that can complicate dosing," said Gregory Hammer, M.D., Professor of Anesthesiology, Perioperative and Pain Medicine, and of Pediatrics at Stanford University. "Olinvyk represents a new alternative for clinicians, due to its rapid onset of action, effective pain relief, and unique profile."

The active ingredient found in Olinvyk is Oliceridine. It is available in injection dosage form. Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, reserve Olinvyk for use in patients for whom alternative treatment options [e.g., non-opioid analgesics or opioid combination products]:

1. Have not been tolerated, or are not expected to be tolerated
2. Have not provided adequate analgesia, or are not expected to provide adequate analgesia.

The cumulative total daily dose should not exceed 27 mg.

Dosage Administration:

1. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.

2. Individualize dosing based on the severity of pain, patient response, prior analgesic experience, and risk factors for addiction, abuse, and misuse.

3. Initiate treatment with a 1.5 mg dose.

4. For patient controlled analgesia (PCA), recommended demand dose is 0.35 mg, with a 6-minute lock-out. A demand dose of 0.5 mg may be considered.

Serious, life-threatening, or fatal respiratory depression may occur. Monitor for respiratory depression, especially during initiation or following a dose increase.
Concomitant use of Olinvyk with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death.
Concomitant use with Serotonergic Drugs may result in serotonin syndrome. Discontinue Olinvyk if serotonin syndrome is suspected.

Nausea, vomiting, dizziness, headache and hypotension are reported side effects of the drug.

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Who developed a Pharmacy Toolkit to help pharmacists engage and educate patients about the safe use, storage, and disposal of pain medicines?

a. CDC
b. CMSA
c. ASHP
d. AAOA
e. FTC

  Answer  

Answer: (d), In collaboration with its pharmacy partners and several state pharmacy associations, Allied Against Opioid Abuse (AAOA) developed a Pharmacy Toolkit to help pharmacists engage and educate patients about the safe use, storage, and disposal of pain medicines.

The AAOA Pharmacy Toolkit includes resources to help pharmacists raise awareness among patients about their rights, risks, and responsibilities associated with prescription opioids.

These resources include: a pharmacy display, patient handout, patient engagement guide, tips for talking with patients and caregivers, prescriber engagement guide, safe storage and disposal training, and social graphics.

To learn more about the Pharmacy Toolkit, please visit:

https://againstopioidabuse.org/

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The FDA has recently approved Xywav for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Another drug Xyrem is available for the same indication in the US. What is a principal advantage of using Xywav over Xyrem?

a. Less side effects
b. Less potential for abuse
c. Low sodium contents
d. More potency
e. Cheaper

  Answer  

The FDA has recently approved Xywav for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Another drug Xyrem is available for the same indication in the US. What is a principal advantage of using Xywav over Xyrem?

a. Less side effects
b. Less potential for abuse
c. Low sodium contents
d. More potency
e. Cheaper

Answer: C

The active ingredients found in Xywav is (calcium, magnesium, potassium, and sodium oxybates) oral solution. It is for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy.

Xywav is an oxybate product with a unique composition of cations resulting in 92 percent less sodium - or approximately 1,000 to 1,500 mg/night - than sodium oxybate at the recommended dosage range of 6 to 9 grams.

Multiple Xywav dosing options are available for adult and pediatric patients. Prescribers can titrate Xywav into unequal doses taken over the course of the night. When patients start Xywav after sodium oxybate, Xywav treatment is initiated at the same dose and regimen as sodium oxybate (gram for gram) and titrated as needed based on efficacy and tolerability.

Xywav makes it possible for patients to have a lower-sodium oxybate treatment option. This may help patients taking sodium oxybate better align with daily sodium intake recommendations including those by the American Heart Association. Excess sodium intake has been linked with increases in blood pressure, hypertension, stroke, and other cardiovascular disease.

Xyrem (Sodium oxybate) carries warnings about its high sodium content,10 and was previously the only product approved to treat both cataplexy and EDS in patients with narcolepsy 7 years of age and older and designated as a standard of care for the treatment of cataplexy and EDS by the American Academy of Sleep Medicine.
Xywav has a Boxed Warning as a central nervous system depressant, and for its potential for abuse and misuse. Because of the risks of CNS depression and abuse and misuse, Xywav is available only through a restricted program under a REMS called the Xywav and Xyrem REMS Program.

Most common adverse reactions in adults are headache, nausea, dizziness, decreased appetite, parasomnia, diarrhea, hyperhidrosis, anxiety and vomiting.

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Entresto is indicated for the treatment of:

a. Hypertension
b. Heart failure
c. Depression
d. Type II diabetes mellitus
e. Panic disorder

  Answer  

Entresto is indicated for the treatment of:

a. Hypertension
b. Heart failure
c. Depression
d. Type II diabetes mellitus
e. Panic disorder

Answer: b. The active ingredients found in Entresto are Sacubitril and Valsartan. Sacubitril is a neprilysin inhibitor whereas Valsartan is an angiotensin II receptor blocker.

It is available as tablets (24/26 mg, 49/51 mg and 97/103 mg).

It is indicated:

1. to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction. It is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other ARB.

2. for the treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged one year and older.



Hypotension, hyperkalemia, cough, dizziness and renal failure are reported side effects of the drug.

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Which of the following statements is/are TRUE ABOUT Trulicity? [Select ALL THAT APPLY].

a. The active ingredient is Dulaglutide.
b. It is indicated for the treatment of migraine.
c. It is a glucagon-like peptide-1 (GLP-1) receptor agonist.
d. Initiate at 0.75 mg subcutaneously once weekly.
e. Contraindicated in patients with a personal or family history of medullary thyroid carcinoma.

  Answer  

Which of the following statements is/are TRUE ABOUT Trulicity? [Select ALL THAT APPLY].

a. The active ingredient is Dulaglutide.
b. It is indicated for the treatment of migraine.
c. It is a glucagon-like peptide-1 (GLP-1) receptor agonist.
d. Initiate at 0.75 mg subcutaneously once weekly.
e. Contraindicated in patients with a personal or family history of medullary thyroid carcinoma.

Answer: (a,c,d,e)

The active ingredient found in Trulicity is Dulaglutide. It is available as an injection (0.75mg/0.5ml, 1.5mg/0.5ml) administered subcutaneously in the abdomen, thigh, or upper arm.

It is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated:

1. as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

2. to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.

Dulaglutide activates the GLP-1 receptor, a membrane-bound cell-surface receptor coupled to adenylyl cyclase in pancreatic beta cells. Dulaglutide increases intracellular cyclic AMP (cAMP) in beta cells leading to glucose-dependent insulin release. Dulaglutide also decreases glucagon secretion and slows gastric emptying.

The drug should be administered once weekly. The drug should be initiated at 0.75 mg subcutaneously once weekly. Dose can be increased to 1.5 mg once weekly for additional glycemic control.

If a dose is missed, administer the missed dose as soon as possible if there are at least 3 days (72 hours) until the next scheduled dose.

It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2.

Nausea, diarrhea, vomiting, abdominal pain, and decreased appetite are commonly reported side effects of the drug.


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Rexulti (Brexpiprazole) is indicated for: [Select ALL THAT APPLY].

a. OCD
b. Schizophrenia
c. Hypertension
d. Arrhythmia
e. Depression

  Answer  

Rexulti (Brexpiprazole) is indicated for: [Select ALL THAT APPLY].

a. OCD
b. Schizophrenia
c. Hypertension
d. Arrhythmia
e. Depression

Answer: b, e
 
The active ingredient found in Rexulti is Brexpiprazole. It is available as tablets (0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg).

The recommended dose is 0.5 to 3 mg per day once daily with or without food.

The mechanism of action of Brexpiprazole in the treatment of major depressive disorder or schizophrenia is unknown. However, the efficacy of Brexpiprazole may be mediated through a combination of partial agonist activity at serotonin 5-HT1A and dopamine D2 receptors, and antagonist activity at serotonin 5-HT2A receptors.

Rexulti (Brexpiprazole)  is an atypical antipsychotic indicated for:

1. Use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD).

2. Treatment of schizophrenia

Dosing adjustments:

1. Moderate to Severe Hepatic Impairment (Child-Pugh score ≥7): Maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia.

2. Moderate, Severe or End-Stage Renal Impairment (ClCr<60 mL/minute): Maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia.

3. Known CYP2D6 Poor Metabolizers: Reduce the usual dosage by half.
 
Weight gain and akathisia are commonly reported side effects of the drug.

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Which of the following information is/are reported signs and symptoms of coronavirus infection? [Select ALL THAT APPLY].

a. fever
b. cough
c. loss of smell
d. difficulty concentrating
e. somnolence

  Answer  

Which of the following information is/are reported signs and symptoms of coronavirus infection? [Select ALL THAT APPLY].

a. fever
b. cough
c. loss of smell
d. difficulty concentrating
e. somnolence

Answer: a,b,c, and d

While a fever and cough have seemed to be the early warning signs of COVID-19, new research shows almost half of hospitalized patients experience a host of neurological problems.

In fact, headaches, dizziness, strokes, weakness, decreased alertness or other neurological symptoms can appear before the more commonly known symptoms of infection with the new coronavirus (known as SARS-COV-2), the researchers said.

Those neurological symptoms can also include loss of smell and taste, seizures, muscle pain and difficulty concentrating.

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Which of the following information is TRUE ABOUT the simultaneous administration of Remdesivir and Chloroquine phosphate?

a. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase Chloroquine phosphate potency in treating coronavirus infection.

b. FDA is warning health care providers that co-administration of Remdesivir and Chloroquine phosphate is not recommended as it may result in reduced antiviral activity of Remdesivir.

c. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase toxicity of Remdesivir in treating coronavirus infection.

d. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase Remdesivir potency in treating coronavirus infection.

e. FDA is recommending health care providers that Remdesivir shall be co-administered with Hydroxychloroquine sulfate since this combination shows 50% effectiveness in controlling coronavirus symptoms compared to co administration of Remdesivir with Chloroquine phosphate.

  Answer  

Which of the following information is TRUE ABOUT the simultaneous administration of Remdesivir and Chloroquine phosphate?

a. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase Chloroquine phosphate potency in treating coronavirus infection.

b. FDA is warning health care providers that co-administration of Remdesivir and Chloroquine phosphate is not recommended as it may result in reduced antiviral activity of Remdesivir.

c. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase toxicity of Remdesivir in treating coronavirus infection.

d. The simultaneous administration of Remdesivir and Chloroquine phosphate will increase Remdesivir potency in treating coronavirus infection.

e. . FDA is recommending health care providers that Remdesivir shall be co-administered with Hydroxychloroquine sulfate since this combination shows 50% effectiveness in controlling coronavirus symptoms compared to co administration of Remdesivir with Chloroquine phosphate.


Answer: b

FDA is warning health care providers that co-administration of Remdesivir and chloroquine phosphate or hydroxychloroquine sulfate is not recommended as it may result in reduced antiviral activity of Remdesivir.

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Which of the following is recently approved biosimilar drug to Neulasta?
 
a. Neupogen
b. Nyvepria
c. Opdivo
d. Taltz
e. Brilinta

  Answer  

Which of the following is recently approved biosimilar drug to Neulasta?
 
a. Neupogen
b. Nyvepria
c. Opdivo
d. Taltz
e. Brilinta

Answer: b
 
The active ingredient found in Nyvepria is Pegfilgrastim-apgf.

Nyvepria, a biosimilar to Neulasta, is approved by the FDA to help reduce the chance of infection due to a low white blood cell count in people with non-myeloid cancer who receive anti-cancer medicines, like chemotherapy, that can cause fever and low white blood cell count. This condition, known as febrile neutropenia, is a common side effect of many types of chemotherapy and lowers the body’s ability to defend itself against infections.

Nyvepria is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia.

Nyvepria is contraindicated in patients with a history of serious allergic reactions to Pegfilgrastim products (e.g. Neulasta) or filgrastim products (e.g. Neupogen).
Bone pain and pain in extremity are reported side effects of the drug.

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What is the probable mechanism of action of Sirturo (Bedaquiline)?

a. Inhibits 5-alpha azo reductase
b. Inhibits DNA gyrase
c. Inhibits mycobacterial ATP synthase
d. Inhibits RNA polymerase
e. Inhibits CGAP ligase

  Answer  

What is the probable mechanism of action of Sirturo (Bedaquiline)?

a. Inhibits 5-alpha azo reductase
b. Inhibits DNA gyrase
c. Inhibits mycobacterial ATP synthase
d. Inhibits RNA polymerase
e. Inhibits CGAP ligase

Answer: c

The active ingredient found in Sirturo is Bedaquiline. is the first anti-TB drug to interfere with bacterial energy metabolism.

Sirturo (Bedaquiline)® specifically inhibits mycobacterial ATP (adenosine 5'-triphosphate) synthase, by binding to subunit c of the enzyme that is essential for the generation of energy in Mycobacterium tuberculosis.

Sirturo (Bedaquiline)® is a diarylquinoline antimycobacterial drug indicated as part of combination therapy in the treatment of adult and pediatric patients (12 to less than 18 years of age and weighing at least 30 kg) with pulmonary multi-drug resistant tuberculosis (MDR-TB).

Reserve Sirturo (Bedaquiline)® for use when an effective treatment regimen cannot otherwise be provided.
 
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