Reference Guide for the California Pharmacy Licensing Exam   Sample Questions

Question 1.
Mrs. X is diagnosed with diabetes. Her physician prescribes her Glyburide 5 mg po qd. She comes to the pharmacy to fill the prescription. She asks: "Do I have to take precautions as with any OTC medications?" Pharmacist may say "yes". Please indicate name of drug.

Name of a drug
_______________________________

Why ?
_______________________________
_______________________________________________

1. Mrs. X has to avoid Bayer Aspirin or other products that may contain salicylate. Aspirin may displace oral sulfonylurea (Glyburide) from protein binding and may prolong the Glyburide-induced hypoglycemia. Concurrent use may require periodic check ups of blood glucose concentration.

Question 2.
Please indicate rare but the most severe side effect of Metformin:

____________________________________

2.(c) Metformin (Glucophage, Glucophage XR) is indicated for the treatment of type II diabetes. It improves the glucose tolerance in patients. Lactic acidosis is a rare but fatal side effect of the drug. The recommended dose of the drug is 500 mg twice a day or 850 mg once a day.

Question 3.
Which of the following drugs must be avoided in patients receiving SMZ/TMP IV infusion ?

a Amoxicillin
b Chloramphenicol
c Cefoperazone
d Ciprofloxacin

3.(c) Intravenous Trimethoprim and Sulfamethoxazole contains 10% ethanol as a solubilizing agent. Cefoperazone may cause severe disulfiram-like reactions with alcohol. Their concurrent use may be strictly prohibited.

Question 4.
Mr. Moose comes to pharmacy and asks pharmacist "I have a 30 softgel capsules of lanoxin 0.125 mg. Can I use instead of Lanoxin (0.125 mg) tablets?

____________________________________________

4. Mr. Moose cannot interchange Lanoxin softgel for Lanoxin tablets due to a bioavailability difference. Lanoxin tablets provide 60 to 80 % bioavailability while Lanoxin soft gels provide 90 to 100 % bioavailability. They are indicated for the treatment of CHF.

Question 5.
Dr. Hame has a 35 year old pregnant patient diagnosed with UTI. Which of the following antibiotics is more safe for her?

a. Ciprofloxacin
b. Levofloxacin
c. Nitrofurantoin
d. Tetracyclin

5. (c) Nitrofurantoin (Macrobid) is classified pregnancy category B. It is indicated for the prevention and treatment of urinary tract infections. It may discolor urine to a dark yellow or brown color. Diarrhea, dizziness, cough, chills and drowsiness are commonly reported side effects of the drug. The recommended dose of the drug is 50 to 100 mg every 6 hours for 7 to 10 days. The other choices such as Ciprofloxacin and Levofloxacin are classified as pregnancy category C and Tetracycline is classified in pregnancy category D.

Question 6.
Please indicate three major adverse effects of Phenytoin:

6.The three major side effects of Phenytoin are:

1. Gingival hyperplasia
2. Ataxia
3. Nystagmus

Question 7.
Mrs.X has been taking the following medications. She was recently diagnosed with CHF. Her principal complaint is a slowing of heartbeat and a problem in breathing. Please indicate the name of the drug that may cause those problems.

7. Disopyramide (Norpace) has a profound A.V. node suppression property. It should be carefully prescribed to patients suffering from CHF. It is classified as a class IA antiarrhythmic agent. The most severe adverse effects of Disopyramide are hypotension, bradycardia and CHF. The recommended dose of the drug is 100 mg to 150 mg every 6 hours, or 200 mg to 300 mg every 12 hours (controlled release). Disopyramide can be replaced by Quinidine or Procainamide.

8. Please fill in the chart to indicate "indication for use" and "trade name"

Trade name           Use
Coreg                     CHF
Prograf                  Organ transplantation
Lescol                    Atherosclerosis
Prozac                   Depression
Celexa                   Depression

Question 9.
A 45 year old male is allergic to Naproxen. Can he take the OTC Alka-Seltzer for heartburn?

Indicate a brief explanation about your answer.

9. No. Alka-Seltzer contains 325 mg Aspirin, 1000 mg citric acid and 1916 mg heat treated sodium bicarbonate. It is indicated for fast relief of heartburn, acid indigestion, sour stomach with headache, or body aches and pain. The patient is allergic to Naproxen (NSAID) and therefore he has to avoid Alka-Seltzer. The recommended therapeutic dose of the drug is dissolved 2 tablets in 4 oz of water every 4 hours not to exceed 8 tablets in 24 hours.

Question 10.
Which of the following is indicated for the treatment of Burkitt’s lymphoma?

a. Mercaptopurine
b. Hydroxyurea
c. Thioguanine
d. Methotrexate

10. (d) Methotrexate is a dihydrofolate reductase inhibitor. It is indicated for the treatment of stage I, II and III Burkitt’s lymphoma. The recommended dose of the drug for treatment of Burkitt’s lymphoma is 10 to 25 mg by mouth daily for 4 to 8 days with 1 week rest intervals. Pulmonary fibrosis, blood dyscrasia, hepatic fibrosis and renal failure are side effects of the drug.

Question 11.
Methotrexate is indicated for the treatment of:

1. Lymphocytic leukemia
2. Psoriasis
3. R.arthritis

a. 1 only
b. 1 & 2 only
c. 2 & 3 only
d. All

11. (d) Methotrexate is indicated for the treatment of psoriasis, rheumatoid arthritis, meningeal leukemia, Burkitt’s lymphoma, osteosarcoma, lymphosarcoma and mycosis fungoids. It is a dihydrofolate reductase inhibitor which reduces formation of tetrahydrofolic acids. This will inhibit growth of rapidly proliferating cells such as epithelial cells. The recommended dose for psoriasis is 10 to 25 mg P.O., I.M. or I.V. in a single weekly dose. The recommended dose in arthritis patients is 7.5 mg by mouth per week in divided doses, with a maximum up to 20 mg per week. The recommended dose in leukemia patient is 3.3 mg/mm2/day P.O, I.M. or I.V. for 4 to 6 weeks.

Question 12.
Riboflavin deficiency may cause:

a. Scurvy
b. Ricketssia
c. Cheilosis
d. Beriberi

12. (c) Riboflavin deficiency may cause cheilosis. The recommended dose is 1.7 mg per day. It may cause yellow discoloration of urine.

Question 13.
Thiamin deficiency may cause:

1. Beriberi
2. Wet beriberi
3. Wernicke’s encephalopathy

a. 1 only
b. 1 & 2 only
c. 2 & 3 only
d. All

13. (d) Thiamine (Vitamin B1) is classified as a water soluble vitamin. It is indicated for treatment and prevention of beriberi, wet beri beri and wernicke’s encephalopathy. Angiodema and CV collapse are reported side effects of the drug.

Question 14.
Which of the following cephalosporins is/are indicated for treatment of CNS infections?

1. Cefotaxime
2. Ceftazidime
3. Cefotetan

a. 1 only
b. 1 & 2 only
c. 2 & 3 only
d. All

14. (b) Cefotaxime and Ceftazidime are third generation cephalosporins. They are highly lipophilic in nature. They can cross the Blood Brain Barrier due to their high lipophilicity. They are indicated for the treatment of CNS infections. The recommended dose of Cefotaxime is 1 gm I.V. or I.M. every 6 to 8 hours. The recommended dose of Ceftazidime is 1 gm I.V. or I.M. every 8 to 12 hours.

Question 15.
Tacrine inhibits which of the following?

a. 5 alfa azo reductase
b. Cyclooxygenase
c. Cholinesterase
d. Monoamine oxidase

15.(c) Tacrine (Cognex) inhibits the acetylcholinesterase enzyme. The inhibition of this enzyme increases neuronal concentrations of acetylcholine. Tacrine is indicated for the treatment of mild to moderate dementia. The recommended dose is 10 mg qid for 6 weeks, with a maximum up to 40 mg po qid for 6 weeks. Agitation, ataxia, insomnia, somnolence, vomiting and diarrhea are reported side effects of the drug.