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Botox (OnabotulinumtoxinA) inhibits the release which of the following?

a. Serotonin
b. Histamine
c. Acetylcholine
d. GABA
e. Dopamine


Botox (OnabotulinumtoxinA) inhibits the release which of the following?

a. Serotonin
b. Histamine
c. Acetylcholine
d. GABA
e. Dopamine

The active ingredient found in Botox is OnabotulinumtoxinA. It is an acetylcholine release inhibitor and a neuromuscular blocking agent.

Botox (OnabotulinumtoxinA) blocks neuromuscular transmission by binding to acceptor sites on motor or autonomic nerve terminals, entering the nerve terminals, and inhibiting the release of acetylcholine. This inhibition occurs as the neurotoxin cleaves SNAP-25, a protein integral to the successful docking and release of acetylcholine from vesicles situated within nerve endings.

When injected intramuscularly at therapeutic doses, Botox (OnabotulinumtoxinA) produces partial chemical denervation of the muscle resulting in a localized reduction in muscle activity. In addition, the muscle may atrophy, axonal sprouting may occur, and extrajunctional acetylcholine receptors may develop. There is evidence that reinnervation of the muscle may occur, thus slowly reversing muscle denervation produced by Botox (OnabotulinumtoxinA).

When injected intradermally, Botox (OnabotulinumtoxinA) produces temporary chemical denervation of the sweat gland resulting in local reduction in sweating.

Following intradetrusor injection, Botox (OnabotulinumtoxinA) affects the efferent pathways of detrusor activity via inhibition of acetylcholine release.

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What are signs and symptoms of preeclampsia?
 
I. a persistent headache
II. swelling of the face or hands
III. shoulder pain
 
a. I only
b. I and II only
c. II and III only
d. All


What are signs and symptoms of preeclampsia?
 
I. a persistent headache
II. swelling of the face or hands
III. shoulder pain
 
a. I only
b. I and II only
c. II and III only
d. All
 
Answer: (d) All. Preeclampsia is a condition during pregnancy where there is a sudden rise in blood pressure and swelling, mostly in the face, hands, and feet.
 
Signs and symptoms associated with preeclampsia:
 
1. a headache that persists
2. swelling of the face or hands
3. changes in eyesight
4. sudden weight gain
5. shoulder pain
6. nausea and vomiting
 
Source: www.pharmacyexam.com


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Which of the following information is/are TRUE ABOUT headaches during menstrual period? [Select All That Apply]
 
a. A menstrual migraine headache may occur before, during, or after a period.
b. Acute migraine headaches may occur when the level of estrogen in the body rises significantly.
c. Around 10% of females who experience migraine report that menstruation is a trigger for these headaches.
d. Premenstrual syndrome headaches typically occur before a period begins.
e. Sensitivity to bright lights and noise is also reported with the menstrual migraine.


Which of the following information is/are TRUE ABOUT headaches during menstrual period? [Select All That Apply]
 
a. A menstrual migraine headache may occur before, during, or after a period.
b. Acute migraine headaches may occur when the level of estrogen in the body rises significantly.
c. Around 10% of females who experience migraine report that menstruation is a trigger for these headaches.
d. Premenstrual syndrome headaches typically occur before a period begins.
e. Sensitivity to bright lights and noise is also reported with the menstrual migraine.
 
Answer: (a, d and e).  
 
A menstrual migraine headache may occur before, during, or after a period whereas premenstrual syndrome (PMS) headaches typically occur before a period begins.
 
Acute migraine headaches are normally reported when the level of estrogen in the body drops (not rises) significantly.
 
Around 60% (not 10%) of females who experience migraine report that menstruation is a trigger for these headaches.
 
Other symptoms of a menstrual migraine headache tend to include:
 
1. sensitivity to bright lights
2. sensitivity to noise
3. throbbing pain on one side of the head
4. nausea
5. vomiting
 
Source: www.pharmacyexam.com


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Which of the following information is/are TRUE ABOUT Oscillopsia? [Select All That Apply]
 
a. It is the sensation that the surrounding environment is constantly in motion when it is, in fact, stationary.
b. It is usually a symptom of conditions that affect eye movement or the eye's ability to stabilize images, especially during movement.
c. It often links to types of ataxia, which is a condition that causes abnormal or involuntary eye movement.
d. The American Psychological Association describe oscillopsia as "the sensation of perceiving oscillating movement of the environment."
e. It is usually associated with neurological conditions, such as multiple sclerosis.


Which of the following information is/are TRUE ABOUT Oscillopsia? [Select All That Apply]
 
a. It is the sensation that the surrounding environment is constantly in motion when it is, in fact, stationary.
b. It is usually a symptom of conditions that affect eye movement or the eye's ability to stabilize images, especially during movement.
c. It often links to types of ataxia, which is a condition that causes abnormal or involuntary eye movement.
d. The American Psychological Association describe oscillopsia as "the sensation of perceiving oscillating movement of the environment."
e. It is usually associated with neurological conditions, such as multiple sclerosis.

Answer: (a, b, d and e).  
 
Oscillopsia is the sensation that the surrounding environment is constantly in motion when it is, in fact, stationary. It usually occurs as a result of conditions that affect eye movement or alter how parts of the eye, inner ear, and brain stabilize images and maintain balance. The American Psychological Association describe oscillopsia as "the sensation of perceiving oscillating movement of the environment."
 
It often links to types of nystagmus (not ataxia), which is a condition that causes abnormal or involuntary eye movement.
 
Some of the most common conditions that experts have associated with oscillopsia include:
 
1. neurological conditions, such as seizures, multiple sclerosis, and superior oblique myokymia
2. brain or head injuries, especially bilateral vestibular cerebellar injuries
3. conditions, such as stroke, that affect the eye muscles or muscles around the eyes
4. conditions that affect or damage the inner ear, including Meniere's disease
5. conditions that cause brain inflammation, such as tumors or meningitis
 
Source: www.pharmacyexam.com


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Pharmacists should be able to recognise red flag signs of Postnatal depression (PND) and refer these patients immediately. Which of the following is/are Red flag signs or symptoms for postnatal depression?
 
I. Recent significant change in mental state or emergence of new psychiatric symptoms
II. New thoughts or acts of violent self-harm.
III. New and persistent expressions of incompetency as a mother, such as being over-critical for not recognising what the baby needs.
 
a. I only
b. I and II only
c. II and III only
d. All


Pharmacists should be able to recognise red flag signs of Postnatal depression (PND) and refer these patients immediately. Which of the following is/are Red flag signs or symptoms for postnatal depression?
 
I. Recent significant change in mental state or emergence of new psychiatric symptoms
II. New thoughts or acts of violent self-harm.
III. New and persistent expressions of incompetency as a mother, such as being over-critical for not recognising what the baby needs.
 
a. I only
b. I and II only
c. II and III only
d. All

Answer: (d).  All. Pharmacists should be able to recognise red flag signs and symptoms of PND and refer these patients immediately.
Red flag signs for postnatal depression:
 

  1. Recent significant change in mental state or emergence of new psychiatric symptoms;
  2. New thoughts or acts of violent self-harm;
  3. New and persistent expressions of incompetency as a mother, such as:
  • Estrangement from the infant;
  • Being over-critical for not recognising what the baby needs;
  • Saying that she/he is not doing things correctly;
  • Saying that she/he is not a good mother for her child;
  • Saying that the baby may be better cared for by someone else;
  • Saying that she/he is not providing good care for her baby or that other parents seem to be more able to look after their babies.
Patients with suicidal thoughts must be referred immediately to specialist perinatal mental health services.

Source: www.pharmacyexam.com
Citation: https://www.pharmaceutical-journal.com/cpd-and-learning/learning-article/postnatal-depression-recognition-and-diagnosis/20207360.article?firstPass=false


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_______________ glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain.
 
a. Neovascular
b. Pigmentary
c. Exfoliation
d. Uveitic


_______________ glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain.
 
a. Neovascular
b. Pigmentary
c. Exfoliation
d. Uveitic

Answer: (a).  Glaucoma is a group of eye diseases that are usually characterized by damage to the optic nerve and gradual vision loss that starts with losing peripheral (side) vision. People who have high eye pressure are at higher risk for glaucoma.
 
Primary glaucomas:

When experts don’t know what causes a type of glaucoma, that type is called a primary glaucoma.
 
Secondary glaucomas:

Sometimes glaucoma is caused by another medical condition — this is called secondary glaucoma.
 
1. Neovascular glaucoma

Treatments: Medicines, laser treatment, surgery
 
Neovascular glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain. It’s usually caused by another medical condition, like diabetes or high blood pressure. 
 
If you have neovascular glaucoma, you may notice:
 

  • Pain or redness in your eye
  • Vision loss
 
This type of glaucoma can be hard to treat. Doctors need to treat the underlying cause (like diabetes or high blood pressure) and use glaucoma treatments to lower the eye pressure that results from it.
 
2. Pigmentary glaucoma
 
Treatments: Medicines, laser treatment, surgery
 
Pigment dispersion syndrome happens when the pigment (color) from your iris (the colored part of your eye) flakes off. The loose pigment may block fluid from draining out of your eye, which can increase your eye pressure and cause pigmentary glaucoma.
 
Young, white men who are near-sighted are more likely to have pigment dispersion syndrome than others. If you have this condition, you may have blurry vision or see rainbow-colored rings around lights, especially when you exercise. 
 
Doctors can treat pigmentary glaucoma by lowering eye pressure, but there currently isn’t a way to prevent pigment from detaching from the iris.
 
3. Exfoliation glaucoma

Treatments: Medicines, laser treatment, surgery
 
Exfoliation glaucoma (sometimes called pseudoexfoliation) is a type of open-angle glaucoma that happens in some people with exfoliation syndrome, a condition that causes extra material to detach from parts of the eye and block fluid from draining. 
 
Recent research shows that genetics may play a role in exfoliation glaucoma. You are at higher risk if someone else in your family has exfoliation glaucoma.
 
This type of glaucoma can progress faster than primary open-angle glaucoma, and often causes higher eye pressure. This means that it’s especially important for people who are at risk to get eye exams regularly. 
 
4. Uveitic glaucoma

Treatments: Medicines, surgery
 
Uveitic glaucoma can happen in people who have uveitis, a condition that causes inflammation (irritation and swelling) in the eye. About 2 in 10 people with uveitis will develop uveitic glaucoma.
 
Experts aren’t sure how uveitis causes uveitic glaucoma, but they think that it may happen because uveitis can cause inflammation and scar tissue in the middle of the eye. This may damage or block the part of the eye where fluid drains out, causing high eye pressure and leading to uveitic glaucoma. 
 
In some cases, the medicines that treat uveitis may also cause uveitic glaucoma or make it worse. This is because corticosteroid medicines may cause increased eye pressure as a side effect.


Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma


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Which of the following types of glaucoma is NOT CONSIDERED a primary glaucoma?
 
a. Open-angle
b. Congenital
c. Pigmentary
d. Angle-closure


Which of the following types of glaucoma is NOT CONSIDERED a primary glaucoma?
 
a. Open-angle
b. Congenital
c. Pigmentary
d. Angle-closure

Answer: (c).  Glaucoma is a group of eye diseases that are usually characterized by damage to the optic nerve and gradual vision loss that starts with losing peripheral (side) vision. People who have high eye pressure are at higher risk for glaucoma.
 
Primary glaucomas:
When experts don’t know what causes a type of glaucoma, that type is called a primary glaucoma.
 
Pigmentary glaucoma is considered secondary glaucoma.
 
1. Open-angle glaucoma

Treatments: Medicines, laser treatment, surgery 
 
Open-angle glaucoma is the most common type in the United States, where 9 in 10 people with glaucoma have the open-angle type. Many people don’t have any symptoms until they start to lose their vision, and people may not notice vision loss right away.
 
Experts aren’t sure what causes open-angle glaucoma, but it may be caused by pressure building up in your eye. If the fluid in your eye can’t drain fast enough, it creates pressure that pushes on a nerve in the back of your eye (the optic nerve). 
 
Over time, the pressure damages the optic nerve, which affects your vision. This can eventually lead to blindness — in fact, open-angle glaucoma causes almost 2 in 10 cases of blindness in African Americans. People with high blood pressure are also at higher risk for this type.
 
2. Normal-tension glaucoma

Treatments: Medicines, laser treatment, surgery
 
Normal-tension glaucoma is a type of open-angle glaucoma that happens in people with normal eye pressure. About 1 in 3 people with open-angle glaucoma have the normal-tension type. 
 
You may be at higher risk for normal-tension glaucoma if you:
 

  • Are of Japanese ancestry
  • Have a family history of normal-tension glaucoma
  • Have had certain heart problems, like an irregular heartbeat
  • Have low blood pressure
 
Experts don’t know what causes normal-tension glaucoma, but research shows that treatments that lower eye pressure can help slow the disease and stop vision loss.
 
3. Angle-closure glaucoma

Treatments: Medicines, laser treatment
 
Angle-closure glaucoma, also called narrow-angle or acute glaucoma, is a medical emergency. Go to the doctor or emergency room immediately if you suddenly have:
 
  • Intense pain in your eye
  • Nausea
  • Red eyes
  • Blurred vision
 
In this type of glaucoma, the outer edge of the iris (the colored part of your eye) blocks fluid from draining out of the front of the eye. The fluid builds up quickly, causing a sudden increase in eye pressure. If it’s not treated, angle-closure glaucoma can cause blindness in just a few days.
 
A doctor can use laser treatment and give you medicine to help the fluid drain. This can lower eye pressure and protect your vision. Your doctor might treat both eyes to prevent future problems, even if you only have angle-closure glaucoma in one eye.
 
Another type of angle-closure glaucoma, sometimes called slow or chronic angle-closure glaucoma, happens more slowly and might not have any symptoms. Your doctor can treat this type with medicines, laser treatments, or surgery.
 
4. Congenital glaucoma

Treatments: Medicines, surgery
 
Some babies are born with glaucoma — this is called congenital glaucoma. About 1 out of 10,000 babies born in the United States have a defect (problem) in the eye that keeps fluid from draining normally.
 
In these cases, you can usually notice the symptoms right away. Children with congenital glaucoma:
 
  • Have cloudy eyes
  • Are sensitive to light
  • Make extra tears
  • May have eyes that are larger than normal
 
Surgery works very well to treat congenital glaucoma. If a doctor does surgery early enough, children with congenital glaucoma usually won’t have any permanent vision loss.
 
Several other types of glaucoma can also develop in children. Any glaucoma that affects babies or children is called pediatric glaucoma.
 
Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma


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Which of the following is/are Type(s) of Refractive Errors? [Select All That Apply]
 
a. myopia
b. hyperopia
c. Astigmatism
d. Presbyopia
 
a. a only
b. a and b only
c. a, b and c only
d. a, b, c and d


Which of the following is/are Type(s) of Refractive Errors? [Select All That Apply]
 
a. myopia
b. hyperopia
c. Astigmatism
d. Presbyopia
 
a. a only
b. a and b only
c. a, b and c only
d. a, b, c and d
 
Answer: (d)  All. Refractive errors happen when the shape of your eye keeps light from focusing correctly on your retina (a light-sensitive layer of tissue at the back of your eye).
Each type of refractive error is different, but they all make it hard to see clearly.

Nearsightedness (myopia):

Nearsightedness makes far-away objects look blurry. It happens when the eyeball grows too long from front to back, or when there are problems with the shape of the cornea (clear front layer of the eye) or the lens (an inner part of the eye that helps the eye focus). These problems make light focus in front of the retina, instead of on it.
Nearsightedness usually starts between ages 6 and 14. Children who spend more time outdoors during these years are less likely to develop nearsightedness, but experts aren’t sure why.

Severe nearsightedness (also called high myopia) can increase the risk of other eye conditions, like retinal detachment (when the retina is pulled away from its normal position).

Farsightedness (hyperopia):

Farsightedness makes nearby objects look blurry. It happens when the eyeball grows too short from front to back, or when there are problems with the shape of the cornea or lens. These problems make light focus behind the retina, instead of on it.

People with farsightedness are usually born with it.

Astigmatism:

Astigmatism can make far-away and nearby objects look blurry or distorted. It happens when the cornea or lens has a different shape than normal, which makes light bend differently as it enters the eye.

Some people with astigmatism are born with it, but many people develop it as children or young adults. People with astigmatism often have another refractive error, like nearsightedness or farsightedness.

Presbyopia:

Presbyopia makes it hard for middle-aged and older adults to see things up close. As you age, the lens in your eye gets harder and less flexible and stops focusing light correctly on the retina.

Everyone gets presbyopia as they get older, usually after age 45. Many people have another refractive error in addition to presbyopia.
 
Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors/types-refractive-errors


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The following warning is currently published on the DEA website:
 
The Drug Enforcement Administration is warning the public including the DEA registrant community to include practitioners and pharmacies about criminals posing as DEA Special Agents, DEA Investigators or other law enforcement personnel as part of an international extortion scheme.


The following warning is currently published on the DEA website:
 
The Drug Enforcement Administration is warning the public including the DEA registrant community to include practitioners and pharmacies about criminals posing as DEA Special Agents, DEA Investigators or other law enforcement personnel as part of an international extortion scheme.
The criminals call the victims (who in most cases previously purchased drugs over the internet or by telephone) and identify themselves as DEA agents or law enforcement officials from other agencies. The impersonators inform their victims that purchasing drugs over the internet or by telephone is illegal, and that enforcement action will be taken against them unless they pay a fine. In most cases, the impersonators instruct their victims to pay the "fine" via wire transfer to a designated location, usually overseas. If victims refuse to send money, the impersonators often threaten to arrest them or search their property. Some victims who purchased their drugs using a credit card also reported fraudulent use of their credit cards. Another scheme involves criminals contacting doctors and pharmacists and stating that they are the subject of an investigation and demanding money to clear up the matter.

Anyone receiving a telephone call from a person purporting to be a DEA special agent, DEA Investigator, or other law enforcement official seeking money should refuse the demand and report the threat using the online form below.

https://www.deadiversion.usdoj.gov/pubs/pressreleases/extortion_scam.htm