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Which of the following rating scales is commonly used to evaluate the severity of extrapyramidal symptoms (EPS)? [Select ALL that apply]

a. SAS
b. BARS
c. AIMS
d. ESRS
e. PDS


Which of the following rating scales is commonly used to evaluate the severity of extrapyramidal symptoms (EPS)? [Select ALL that apply]

a. SAS
b. BARS
c. AIMS
d. ESRS
e. PDS

Answer: (a,b,c,d). Extrapyramidal symptoms (EPS) are drug-induced movement disorders that include acute and tardive symptoms.

These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), Parkinsonism (characteristic symptoms such as rigidity, bradykinesia, and tremor), and tardive dyskinesia (irregular, jerky movements).

Since it is difficult to measure extrapyramidal symptoms, rating scales are commonly used to assess the severity of movement disorders.

The Simpson-Angus Scale (SAS), Barnes Akathisia Rating Scale (BARS), Abnormal Involuntary Movement Scale (AIMS), and Extrapyramidal Symptom Rating Scale (ESRS) are rating scales frequently used for such assessment and are not weighted for diagnostic purposes.

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Poison Ivy rash is an example of:

a. Type I Hypersensitivity
b. Type II Hypersensitivity
c. Type III Hypersensitivity
d. Type IV Hypersensitivity
e. Type V Hypersensitivity


Poison Ivy rash is an example of:

a. Type I Hypersensitivity
b. Type II Hypersensitivity
c. Type III Hypersensitivity
d. Type IV Hypersensitivity
e. Type V Hypersensitivity

Answer: (d), Type 4 hypersensitivity is often called delayed type. Delayed hypersensitivity does not start to be noticeable until several hours to a full day after exposure to the antigen. It may last for over a week.

Poison ivy rash is caused by an allergic reaction to an oily resin called urushiol (u-ROO-she-ol). This oil is in the leaves, stems and roots of poison ivy, poison oak and poison sumac. Urushiol, which is a hapten, when absorbed through the skin from a poison ivy plant, it (urushiol) undergoes oxidation in the skin cells to generate the actual hapten, a reactive molecule called a quinone, which then reacts with skin proteins to form hapten adducts.

T lymphocytes recognize the foreign substances, usually after the antigen is eaten, degraded, and presented (in pieces) by so-called antigen-presenting cells such as Langerhans cells in the skin, or macrophages. Urushiol metabolites (metabolite of Poison Ivy) are presented by this and other mechanisms. The T lymphocytes pour out inflammatory signal substances called cytokines. These call in armies of white blood cells called monocytes, which become macrophages. The macrophages become activated by the cytokines and attack everything in the vicinity, and can cause severe tissue damage.

Usually, the first exposure causes only sensitization, in which there is a proliferation of effector T-cells. After a subsequent, second exposure, the proliferated T-cells can become activated, generating an immune reaction that produces typical blisters of a poison ivy exposure.


In addition to poison ivy, a good example is the skin reaction to injected tuberculosis antigen. In fact, when tuberculosis bacteria infect the lung, it is the delayed hypersensitivity against them which destroys the lung. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response.

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Which of the following information about Zurampic is/are TRUE? [Select All that apply].

a. Acute liver failure has reported with Zurampic.
b. Zurampic should be used in combination with a xanthine oxidase inhibitor.
c. An active ingredient found in Zurampic is Lesinurad.
d. Zurampic is a xanthine oxidase inhibitor.
e. Zurampic is indicated for the treatment of hyperuricemia associated with gout.


Which of the following information about Zurampic is/are TRUE? [Select All that apply].

a. Acute liver failure has reported with Zurampic.
b. Zurampic should be used in combination with a xanthine oxidase inhibitor.
c. An active ingredient found in Zurampic is Lesinurad.
d. Zurampic is a xanthine oxidase inhibitor.
e. Zurampic is indicated for the treatment of hyperuricemia associated with gout.

Answer: (b,c,e). Zurampic (Lesinurad) is a URAT1 inhibitor. It is available as blue film-coated tablets for oral administration containing 200 mg Lesinurad. It should be used in combination with a xanthine oxidase inhibitor. Lesinurad reduces serum uric acid levels by inhibiting the function of transporter proteins involved in uric acid reabsorption in the kidney. It is indicated in combination with a xanthine oxidase inhibitor for the treatment of hyperuricemia associated with gout in patients who have not achieved target serum uric acid levels with a xanthine oxidase inhibitor alone.

Zurampic (Lesinurad) is not recommended for the treatment of asymptomatic hyperuricemia. Zurampic (Lesinurad) should not be used as monotherapy.

Zurampic (Lesinurad) tablets are for oral use and should be co-administered with a xanthine oxidase inhibitor, including allopurinol or febuxostat. Zurampic (Lesinurad) is recommended at 200 mg once daily. This is also the maximum daily dose. Zurampic (Lesinurad) should be taken by mouth, in the morning with food and water.

Zurampic (Lesinurad) causes an increase in renal uric acid excretion, which may lead to renal events including transient increases in serum creatinine, renal-related adverse reactions, and kidney stones. These renal events occurred more frequently in patients receiving Zurampic (Lesinurad) 400 mg, when used as monotherapy or in combination with a xanthine oxidase inhibitor. Kidney function is required to monitor.

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Which of the following HMG-CoA inhibitors can be taken during any time of the day with or without food? [Select All that apply]

a. Atorvastatin
b. Pravastatin
c. Simvastatin
d. Pitavastatin
e. Rosuvastatin


Which of the following HMG-CoA inhibitors can be taken during any time of the day with or without food? [Select All that apply]

a. Atorvastatin
b. Pravastatin
c. Simvastatin
d. Pitavastatin
e. Rosuvastatin

Answer: (a,b,d,e).



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Which of the following information is/are TRUE about preparing TPN formulation? [Select ALL THAT APPLY].

a. A lipid emulsion in a three-in-one admixture obscures the presence of calcium phosphate precipitates.
b. The solubility of the added calcium should be calculated from the volume at the time the calcium is added and should NOT be based upon the final volume.
c. If the amount of calcium or phosphate which must be added is likely to cause a precipitate, some or all of the calcium should be administered separately.
d. If a three-in-one admixture is medically necessary, then add the calcium before the lipid emulsion.
e. When adding calcium and phosphate to an admixture, the calcium should be added first.


Which of the following information is/are TRUE about preparing TPN formulation? [Select ALL THAT APPLY].

a. A lipid emulsion in a three-in-one admixture obscures the presence of calcium phosphate precipitates.
b. The solubility of the added calcium should be calculated from the volume at the time the calcium is added and should NOT be based upon the final volume.
c. If the amount of calcium or phosphate which must be added is likely to cause a precipitate, some or all of the calcium should be administered separately.
d. If a three-in-one admixture is medically necessary, then add the calcium before the lipid emulsion.
e. When adding calcium and phosphate to an admixture, the calcium should be added first.

Answer: (a,b,c,d). TPN solutions are made according to a variety of formulations and compounding protocols. Thus, there are possibilities of calcium phosphate precipitates and many other chemical incompatibilities. Precipitates could develop because of a number of factors such as: the concentration, pH, and phosphate content of the amino acid solutions; the calcium and phosphorous additives; the order of mixing; the mixing process; or the compounder. The presence of a lipid emulsion in the TPN admixture would obscure the presence of any precipitate.

Because of the potential for life threatening events, caution should be taken to ensure that precipitates have not formed in any parenteral nutrition admixtures.

1. The amounts of phosphorous and of calcium added to the admixture are critical. The solubility of the added calcium should be calculated from the volume at the time the calcium is added. It should not be based upon the final volume.

Some amino acid injections for TPN admixtures contain phosphate ions (as a phosphoric acid buffer). These phosphate ions and the volume at the time the phosphate is added should be considered when calculating the concentration of phosphate additives. Also, when adding calcium and phosphate to an admixture, the phosphate should be added first.

2. The line should be flushed between the addition of any potentially incompatible components.

3. A lipid emulsion in a three-in-one admixture obscures the presence of a precipitate. Therefore, if a lipid emulsion is needed, either:

(1). use a two-in-one admixture with the lipid infused separately, or
(2). if a three-in-one admixture is medically necessary, then add the calcium before the lipid emulsion and according to the recommendations in number 1 above.

If the amount of calcium or phosphate which must be added is likely to cause a precipitate, some or all of the calcium should be administered separately. Such separate infusions must be properly diluted and slowly infused to avoid serious adverse events related to the calcium.

4. A filter should be used when infusing either central or peripheral parenteral nutrition admixtures. Standards of practice vary, but the following is suggested: a 1.2 micron air eliminating filter for lipid containing admixtures, and a 0.22 micron air eliminating filter for nonlipid containing admixtures.

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Which of the following is strong CYP1A2 inhibitor? [Select All that apply].

a. Fluvoxamine
b. Ciprofloxacin
c. Caffeine
d. Fluoxetine
e. Cimetidine


Which of the following is strong CYP1A2 inhibitor? [Select All that apply].

a. Fluvoxamine
b. Ciprofloxacin
c. Caffeine
d. Fluoxetine
e. Cimetidine

Answer: (a,b). Dose adjustments may be necessary in patients with concomitant use of:

Strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin, or enoxacin);

Moderate or weak CYP1A2 inhibitors (e.g., oral contraceptives, or caffeine);

CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline);

CYP3A4 inducers (e.g., phenytoin, carbamazepine, St. John's wort, and rifampin); or

CYP1A2 inducers (e.g., tobacco smoking).

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WARNING!

Please be aware of the scam, originally brought to our attention by one of our customer. This company website URL is rx-exam.com. The website phone number is 123-456-7890 - which itself suggests it is a fraud. They are claiming to sell materials from their websites for various pharmacy related exams. All materials are offered for online purchase. Many customers have lost their money since after purchasing using credit cards; they don't receive any material.

Please DO NOT PURCHASE any material from this site www.rx-exam.com.

PharmacyExam (RxExam) is not affiliated with this company and bears no responsibility for any financial loss. Please pass this message to your friends. The authenticated web site for our company is www.pharmacyexam.com

Thank you.

Founder and President

Manan Shroff


WARNING!

Please be aware of the scam, originally brought to our attention by one of our customer.This company website URL is rx-exam.com. The website phone number is 123-456-7890 - which itself suggests it is a fraud.They are claiming to sell materials from their websites for various pharmacy related exams. All materials are offered for online purchase. Many customers have lost their money since after purchasing using credit cards; they don't receive any material.

PleaseDO NOT PURCHASEany material from this sitewww.rx-exam.com.

PharmacyExam (RxExam) is not affiliated with this company and bears no responsibility for any financial loss. Please pass this message to your friends. The authenticated web site for our company iswww.pharmacyexam.com

Thank you.

Founder and President

Manan Shroff


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Test 3


Test 3


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Veklury must be administered:

a. IV infusion
b. Subcutaneously
c. Intramuscularly
d. Orally
e. Rectally


Veklury must be administered:

a. IV infusion
b. Subcutaneously
c. Intramuscularly
d. Orally
e. Rectally

Answer: (a). The active ingredient found in Veklury is Remdesivir. Veklury (Remdesivir) is authorized for use under an Emergency Use Authorization (EUA) only for the treatment of adult and pediatric patients hospitalized with suspected or laboratory-confirmed COVID-19, and for whom use of an intravenous (IV) agent is clinically appropriate. Veklury must be administered via IV infusion. It is only administered intravenously in a hospital setting under the care of a physician.

Remdesivir is an adenosine nucleotide prodrug that distributes into cells where it is metabolized to form the pharmacologically active nucleoside triphosphate metabolite. Metabolism of Remdesivir to Remdesivir triphosphate has been demonstrated in multiple cell types. Remdesivir triphosphate acts as an analog of adenosine triphosphate (ATP) and competes with the natural ATP substrate for incorporation into nascent RNA chains by the SARS-CoV-2 RNA-dependent RNA polymerase, which results in delayed chain termination during replication of the viral RNA. Remdesivir triphosphate is a weak inhibitor of mammalian DNA and RNA polymerases with low potential for mitochondrial toxicity.

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What is a strain number of influenza virus in A/Texas/50/2012 (H3N2)?

a. A
b. Texas
c. 50
d. 2012
e. H3N2


What is a strain number of influenza virus in A/Texas/50/2012 (H3N2)?

a. A
b. Texas
c. 50
d. 2012
e. H3N2

Answer: (c) Influenza is named according to the type, the location of initial isolation, the strain designation, and the year of isolation. For example, A/Texas/50/2012 (H3N2), or H3N2, is influenza type A with origin in Texas, with strain No. 50, isolated in 2012 and of the H3N2 subtype.

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