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Which of the following is commonly known as “Purple Pill”?
 
a. Prilosec
b. Tagamet
c. Protonix
d. Axid
e. Nexium


Which of the following is commonly known as “Purple Pill”?
 
a. Prilosec
b. Tagamet
c. Protonix
d. Axid
e. Nexium
 
Answer: (e) Esomeprazole (Nexium). Esomeprazole (Nexium) is the S-Isomer of Omeprazole (Prilosec). It is classified as a Proton Pump Inhibitor (PPI). It is indicated for the treatment of duodenal ulcer, gastric ulcer, Zollinger Ellison Syndrome and GERD. The OTC version of Esomeprazole (Nexium) 24 HR is also commonly known as "Purple Pill".
 
It is supplied in delayed-release capsules and in packets for a delayed-release oral suspension. Each delayed-release capsule contains 20 mg, or 40 mg of Esomeprazole (Nexium). Each packet of Esomeprazole (Nexium) for delayed-release oral suspension contains 2.5 mg, 5 mg, 10 mg, 20 mg, or 40 mg of Esomeprazole (Nexium), in the form of the same enteric-coated granules used in Esomeprazole (Nexium) delayed-release capsules.
 
The recommended dose is 20 to 40 mg once daily for 4 to 8 weeks.
 
Diarrhea, nausea, flatulence, abdominal pain, constipation, and dry mouth are commonly reported side effects of Esomeprazole (Nexium).
 
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Coricidin HBP Night is contraindicated to use in patients suffering from:
 
I.  Hypertension
II. Glaucoma
III. BPH
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


Coricidin HBP Night is contraindicated to use in patients suffering from:
 
I.  Hypertension
II. Glaucoma
III. BPH
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All
 
Answer: (d) II and III only. All Coricidin HBP (High Blood Pressure) products are free of decongestants and therefore they can safely be used in patients suffering from high blood pressure. The active ingredients found in Coricidin HBP Night are 500mg Acetaminophen, 10mg Dextromethorphan Hydrobromide and 2mg Chlorpheniramine. The active ingredients found in Coricidin HBP Day are 10mg Dextromethorphan Hydrobromide and 200mg Guaifenesin.
 
It is indicated for the symptomatic relief of cold and cough, runny nose and sneezing, and bronchial irritation. Since Coricidin HBP Night contains anti-histamine (Chlorpheniramine), it shall be carefully prescribed to patients suffering from glaucoma or BPH.
 
The recommended dose is 1 tablet every 6 hours, not more than 4 tablets in 24 hours.
 
Nausea, vomiting, sedation, drowsiness, dizziness and blurred vision are commonly reported side effects of the drug.
 
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Which of the following information about Folic acid is NOT TRUE?
 
a. It is indicated for prevention of neural tube defects in pregnancy.
 
b. It is indicated for the treatment of megaloblastic anemia.
 
c. The recommended daily allowance is 400 mg per day.
 
d. It is a water-soluble vitamin that has antidepressant, antiproliferative, anti-teratogenic, gingival and anti-inflammatory effects.
 
e. Erythema, pruritus, urticaria, irritability, nausea, bloating and flatulence are reported side effects of the vitamin.


Which of the following information about Folic acid is NOT TRUE?
 
a. It is indicated for prevention of neural tube defects in pregnancy.
 
b. It is indicated for the treatment of megaloblastic anemia.
 
c. The recommended daily allowance is 400 mg per day.
 
d. It is a water-soluble vitamin that has antidepressant, antiproliferative, anti-teratogenic, gingival and anti-inflammatory effects.
 
e. Erythema, pruritus, urticaria, irritability, nausea, bloating and flatulence are reported side effects of the vitamin.
 
Answer: (c) is NOT TRUE. Folic acid is a water-soluble vitamin that has antidepressant, antiproliferative, anti-teratogenic, gingival and anti-inflammatory effects.  It is indicated for prevention of neural tube defects in pregnancy. It is also indicated for the treatment of megaloblastic anemia. It shall not be used in presence of pernicious and megaloblastic anemia due to Vit B12 deficiency.
 
The recommended daily allowance is 400 mcg (NOT mg) per day. Erythema, pruritus, urticaria, irritability, nausea, bloating and flatulence are reported side effects of the drug.
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A pharmacist receives a new prescription. The prescription reads:
 
Bydureon 2mg SC every day for type II diabetes x 30 days.
Refill: 5 times
 
Which of the following is the most appropriate action by a pharmacist?
 
a. Fill as it is.
b. Question the physician about the indication of the drug.
c. Question the physician about the refill quantity of the drug.
d. Question the physician about the dosage frequency of the drug.
e. Question the physician about the dosage strength of the drug.


A pharmacist receives a new prescription. The prescription reads:
 
Bydureon 2mg SC every day for type II diabetes x 30 days.
Refill: 5 times
 
Which of the following is the most appropriate action by a pharmacist?
 
a. Fill as it is.
b. Question the physician about the indication of the drug.
c. Question the physician about the refill quantity of the drug.
d. Question the physician about the dosage frequency of the drug.
e. Question the physician about the dosage strength of the drug.
 
Answer:(d). The active ingredient found in Bydureon is Exenatide indicated for the treatment of type II diabetes mellitus. It is an incretin mimetic agent. Incretins, such as glucagon-like peptide-1 (GLP-1), enhance glucose-dependent insulin secretion and exhibit other antihyperglycemic actions following their release into the circulation from the gut. Bydureon is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion by the pancreatic beta-cell, suppresses inappropriately elevated glucagon secretion, and slows gastric emptying.
 
Bydureon is an extended-release formulation of Exenatide, administered as an injection once every 7 days (weekly). It is also available under the trade name Byetta. Byetta is an immediate release solution of Exenatide administered by SC route. Byetta should be initiated at 5 mcg administered twice daily at any time within the 60-minute period before the morning and evening meals (or before the two main meals of the day, approximately 6 hours or more apart).
 
Nausea, vomiting, diarrhea, dyspepsia, injection site reactions, constipation and hypoglycemia are commonly reported side effects of Bydureon.
 
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The active ingredient found in Tavist ND is/are:
 
I. Clemastine
II. Pseudoephedrine
III. Loratadine
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


The active ingredient found in Tavist ND is/are:
 
I. Clemastine
II. Pseudoephedrine
III. Loratadine
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All

Answer:(b), Loratadine. Normally, the active ingredient found in Tavist is Clemastine. It is indicated for the treatment of seasonal and perennial allergic rhinitis; and chronic idiopathic urticaria. The recommended dose is 1.34 mg orally twice a day. Dosage may be increased as required, but not to exceed 2.68 mg orally 3 times a day.
 
Sedation, sleepiness, dizziness, disturbed coordination, epigastric distress, thickening of bronchial secretions are commonly reported side effects of Clemastine (Tavist).
 
The active ingredient found in Tavist ND is 10 mg Loratadine.
 
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Which of the following is the first combination pill approved to treat chronic HCV genotype 1 infection?
 
a. Vitekta
b. Tybost
c. Movantik
d. Harvoni
e. Contrave


Which of the following is the first combination pill approved to treat chronic HCV genotype 1 infection?
 
a. Vitekta
b. Tybost
c. Movantik
d. Harvoni
e. Contrave

Answer: (d). Ledipasvir and Sofosbuvir (Harvoni) . Ledipasvir and Sofosbuvir (Harvoni) is the first combination pill approved to treat chronic HCV genotype 1 infection.

Harvoni is a fixed-dose combination of ledipasvir, a hepatitis C virus (HCV) NS5A inhibitor, and sofosbuvir, an HCV nucleotide analog NS5B polymerase inhibitor, and is indicated for the treatment of chronic hepatitis C virus (HCV) in adults and pediatric patients 3 years of age and older:

1. Genotype 1, 4, 5, or 6 infection without cirrhosis or with compensated cirrhosis.
2. Genotype 1 infection with decompensated cirrhosis, in combination with ribavirin.
3. Genotype 1 or 4 infection who are liver transplant recipients without cirrhosis or with compensated cirrhosis, in combination with ribavirin.
 
It is available as tablets (90mg Ledipasvir/400 mg Sofosbuvir, 45mg Ledipasvir/200 mg Sofosbuvir)  and oral pellets (45 mg of Ledipasvir and 200 mg of Sofosbuvir, 33.75 mg of Ledipasvir and 150 mg of Sofosbuvir).
 
The recommended dose in an adult patient is  one tablet (90 mg of Ledipasvir and 400 mg of Sofosbuvir) taken orally once daily with or without food.
 
The most common side effects reported in clinical trial participants were fatigue and headache.
 
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Which of the following Oxybutynin formulations is indicated for the symptoms of detrusor overactivity associated with a condition called Spina bifida?
 
I. Ditropan
II. Oxytrol
III. Ditropan XL
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


Which of the following Oxybutynin formulations is indicated for the symptoms of detrusor overactivity associated with a condition called Spina bifida?
 
I. Ditropan
II. Oxytrol
III. Ditropan XL
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All
 
Answer: (b). Oxybutynin (Ditropan XL) is an antispasmodic, anticholinergic agent. Each Oxybutynin (Ditropan XL) Extended Release Tablet contains 5 mg, 10 mg, or 15 mg of Oxybutynin chloride USP, formulated as a once-a-day controlled-release tablet for oral administration. Oxybutynin (Ditropan XL) uses osmotic pressure to deliver oxybutynin chloride at a controlled rate over approximately 24 hours.
 
Oxybutynin (Ditropan XL) is indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. It is also indicated in the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).
 
Oxybutynin (Ditropan XL) must be swallowed whole with the aid of liquids, and must not be chewed, divided, or crushed. It may be administered with or without food. The recommended starting dose of Oxybutynin (Ditropan XL) in adult is 5 or 10 mg once daily at approximately the same time each day. Dosage may be adjusted in 5-mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 30 mg/day).
 
For pediatric patients aged 6 years of age and older, the recommended starting dose of Oxybutynin (Ditropan XL) is 5 mg once daily at approximately the same time each day. Dosage may be adjusted in 5-mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 20 mg/day).
 
Dry mouth, constipation, blurred vision and vasodilation are commonly reported side effects of Oxybutynin (Ditropan XL).
 
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Cordarone shall be carefully prescribed to patients suffering from:
 
a. Hypertension
b. Arrhythmia
c. Depression
d. Hyperthyroidism
e. Seizure
 


Cordarone shall be carefully prescribed to patients suffering from:
 
a. Hypertension
b. Arrhythmia
c. Depression
d. Hyperthyroidism
e. Seizure
 
Answer: (d). Amiodarone (Cordarone) is a member of a class of antiarrhythmic drugs with predominantly Class III (Vaughan Williams' classification) effects, available for oral administration as pink, scored tablets containing 200 mg of Amiodarone hydrochloride.
 
Amiodarone (Cordarone) contains 37.3% iodine by weight. Therefore, it shall be carefully prescribed to patients suffering from hypo-hyper-thyroidism.
 
Because of its life-threatening side effects and the substantial management difficulties associated with its use, Amiodarone (Cordarone) is indicated only for the treatment of the following documented, life-threatening recurrent ventricular arrhythmias when these have not responded to documented adequate doses of other available antiarrhythmics or when alternative agents could not be tolerated.
 
1. Recurrent ventricular fibrillation.
 
2. Recurrent hemodynamically unstable ventricular tachycardia.
 
Loading doses of 800 to 1,600 mg/day are required for 1 to 3 weeks (occasionally longer) until initial therapeutic response occurs. Administration of Amiodarone (Cordarone) in divided doses with meals is suggested for total daily doses of 1,000 mg or higher, or when gastrointestinal intolerance occurs. If side effects become excessive, the dose should be reduced.
 
When adequate arrhythmia control is achieved, or if side effects become prominent, Amiodarone (Cordarone) dose should be reduced to 600 to 800 mg/day for one month and then to the maintenance dose, usually 400 mg/day.
 
Since grapefruit juice is known to inhibit CYP3A4-mediated metabolism of oral amiodarone in the intestinal mucosa, resulting in increased plasma levels of Amiodarone, grapefruit juice should not be taken during treatment with oral Amiodarone.
 
Since amiodarone is a substrate for CYP3A4 and CYP2C8, drugs/substances that inhibit CYP3A4 may decrease the metabolism and increase serum concentrations of Amiodarone.
 
Hepatic injury, hypothyroidism, hyperthyroidism, tremor, poor coordination and pulmonary fibrosis are commonly reported side effects of Amiodarone (Cordarone).
 
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Which of the following shall be measured before initiating Inspra therapy?
 
a. blood glucose level
b. amino acid (alanine) level
c. serum potassium level
d. INR ratio
e. LDL level


Which of the following shall be measured before initiating Inspra therapy?
 
a. blood glucose level
b. amino acid (alanine) level
c. serum potassium level
d. INR ratio
e. LDL level
 
Answer: Serum potassium level. Eplerenone (Inspra) is a blocker of aldosterone binding at the mineralocorticoid receptor. It is available for oral administration contains 25 mg or 50 mg of Eplerenone (Inspra). It is indicated for the treatment of Congestive Heart Failure Post-Myocardial Infarction and Hypertension.
 
Treatment should be initiated at 25 mg once daily and titrated to the recommended dose of 50 mg once daily, preferably within 4 weeks as tolerated by the patient. Eplerenone (Inspra) may be administered with or without food.
 
Serum potassium should be measured before initiating Eplerenone (Inspra) therapy, within the first week, and at one month after the start of treatment or dose adjustment. Serum potassium should be assessed periodically thereafter.
 
For hypertensive patients receiving moderate CYP3A4 inhibitors (e.g., erythromycin, saquinavir, verapamil, and fluconazole), the starting dose of Eplerenone (Inspra) should be reduced to 25 mg once daily. In all patients taking Eplerenone (Inspra) who start taking a moderate CYP3A4 inhibitor, check serum potassium and serum creatinine in 3-7 days.
 
Hyperkalemia, dizziness, diarrhea and abdominal pain are reported side effects of Eplerenone (Inspra).
 
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Zetia is indicated for the treatment of:
 
I. Hyperlipidemia
II. Homozygous Familial Hypercholesterolemia
III. Sitosterolemia
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All


Zetia is indicated for the treatment of:
 
I. Hyperlipidemia
II. Homozygous Familial Hypercholesterolemia
III. Sitosterolemia
 
a. I only
b. III only
c. I and II only
d. II and III only
e. All
 
Answer (e), All. Ezetimibe (Zetia), administered alone, is indicated as adjunctive therapy to diet for the reduction of elevated total cholesterol (total-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), and nonhigh- density lipoprotein cholesterol (non-HDL-C) in patients with primary (heterozygous familial and nonfamilial) hyperlipidemia.
 
The combination of Ezetimibe (Zetia) and Atorvastatin or Simvastatin is indicated for the reduction of elevated total-C and LDL-C levels in patients with Homozygous Familial Hypercholesterolemia (HoFH).
 
It is also indicated as adjunctive therapy to diet for the reduction of elevated sitosterol and campesterol levels in patients with homozygous familial sitosterolemia.
 
The recommended dose of Ezetimibe (Zetia) is 10 mg once daily with or without food. Liver enzyme abnormalities, rhabdomyolysis and myopathy are commonly reported side effects of Zetia.




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