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What is the primary sign or symptom that differentiate bulimia from anorexia? [Select All That Apply]

a. lose weight rapidly
b. eating in secret
c. frequent overeating
d. developing acid reflux
e. developing anemia


What is the primary sign or symptom that differentiate bulimia from anorexia? [Select All That Apply]

a. lose weight rapidly
b. eating in secret
c. frequent overeating
d. developing acid reflux
e. developing anemia

Answer: (b,c and d). According to the National Institute of Mental Health, about 0.6% of adults in the United States experienced anorexia between 2001 and 2003, compared to 0.3% who experienced bulimia.

There are essential differences between anorexia and bulimia, and it is possible for a person to have both at the same time.

People with anorexia and bulimia may fixate on weight and appearance, and they may have a distorted body image. Both conditions result in a person trying to lose weight using unhealthy strategies.

There are key differences between anorexia and bulimia. People with anorexia tend to adopt extreme diets. They may restrict their food intake to a degree that can lead to malnourishment and even death.

Some people with anorexia exercise to excess. If a person is already malnourished, this amount of exercise may cause them to faint or experience other potentially severe adverse effects. Also, a person with anorexia may vomit or take laxatives to lose weight.

The primary characteristic of bulimia is episodes of binge eating followed by 'purging.' An episode may involve overeating and later vomiting, using laxatives, or administering enemas to get rid of the calories consumed.

The primary symptom of anorexia is restricting food intake with extreme dieting. The main symptom of bulimia is compensating for episodes of overeating by trying to purge the food.

Anorexia can cause a person to:

  1. lose weight rapidly
  2. avoid meals
  3. eat very little at meals
  4. try to hide how much they eat
  5. have brittle hair and nails
  6. fixate on their weight
  7. develop anemia
  8. have constipation
  9. experience weakness
  10. experience fainting and fatigue
  11. stop menstruating, which doctors call amenorrhea
  12. develop infertility
  13. experience organ failure

Some signs and symptoms of bulimia include:

  1. frequent overeating
  2. eating in secret
  3. disappearing after meals
  4. having a swollen throat or neck
  5. developing acid reflux
  6. having oral health problems, such as tooth loss or broken teeth
  7. experiencing severe dehydration
  8. having electrolyte imbalances, which can cause health problems

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Which of the following is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening of these fibers?

a. Dilated cardiomyopathy
b. Hypertrophic cardiomyopathy
c. Restrictive cardiomyopathy
d. Arrhythmogenic cardiomyopathy


Which of the following is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening of these fibers?

a. Dilated cardiomyopathy
b. Hypertrophic cardiomyopathy
c. Restrictive cardiomyopathy
d. Arrhythmogenic cardiomyopathy

Answer: (b). Hypertrophic cardiomyopathy.

1. Dilated cardiomyopathy: Dilated cardiomyopathy is the most common form of the disease. It typically occurs in adults between the ages of 20 and 60 years.
The disease often starts in the left ventricle, but it can eventually also affect the right ventricle.
Dilated cardiomyopathy can affect the structure and function of the atria, too.

2. Hypertrophic cardiomyopathy:

Hypertrophic cardiomyopathy is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening or "hypertrophy" of these fibers. The thickening makes the chambers of the heart stiff and affects blood flow. It can also increase the risk of electrical disturbances, called arrhythmias.
According to the Children's Cardiomyopathy Foundation, it is the second most common form of cardiomyopathy in children. In about one-third of affected children, diagnosis occurs before the age of 1 year.

3. Restrictive cardiomyopathy:

Restrictive cardiomyopathy occurs when the tissues of the ventricles become rigid and cannot fill with blood properly. Eventually, it may lead to heart failure. It is more common in older adults and can result from infiltrative conditions - those involving the accumulation of abnormal substances in bodily tissues - such as amyloidosis.

4. Arrhythmogenic cardiomyopathy:

In arrhythmogenic cardiomyopathy, fibrotic and fatty tissue replaces the healthy tissues of the right ventricle, which may cause irregular heart rhythms. In some cases, this process can also occur in the left ventricle.

According to research in the journal Circulation Research, arrhythmogenic cardiomyopathy increases the risk of sudden cardiac death, especially in young people and athletes. It is a hereditary genetic condition.

Symptoms:

In some cases, usually mild ones, there are no symptoms of cardiomyopathy.

However, as the condition progresses, a person may experience the following symptoms with varying degrees of severity:

  1. fatigue
  2. shortness of breath
  3. swelling of the legs and ankles
  4. heart palpitations
  5. dizziness
  6. fainting

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Which of the following statements is/are TRUE about postnatal depression (PND)? [Select All That Apply]
 
a. About 10% of women experiencing a mental health problem during pregnancy or postpartum.
b. PND can begin at any time within one year after delivery.
c. Patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy
d. PND can also occur following miscarriage, stillbirth or in parents who adopt a child.
e. Asian women and women from a non-English speaking background may be affected to a greater extent to PND.



Which of the following statements is/are TRUE about postnatal depression (PND)? [Select All That Apply]
 
a. About 10% of women experiencing a mental health problem during pregnancy or postpartum.
b. PND can begin at any time within one year after delivery.
c. Patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy
d. PND can also occur following miscarriage, stillbirth or in parents who adopt a child.
e. Asian women and women from a non-English speaking background may be affected to a greater extent to PND.

Answer: (a,b,c,d,e).  All.
 
Pharmacists are likely to encounter patients affected by postnatal depression, therefore the ability to identify signs of this under-recognised disorder is essential for appropriate and prompt referral for help and support.
 
Maternal suicide remains the leading cause of death from a direct cause in the postnatal period, accounting for around 22% of maternal deaths reported in the UK between 2014 and 2016. With around 10% of women experiencing a mental health problem during pregnancy or postpartum, it is important for all healthcare professionals to understand and recognise the risk factors for perinatal mental health problems and know where to refer patients.
 
Postnatal depression (PND) can begin at any time within one year after delivery. It is a relatively common condition that occurs in around 10–15% of women following childbirth and around 10% of new fathers, although it is thought that the true prevalence is higher than this.
 
PND can also occur following miscarriage, stillbirth or in parents who adopt a child. In England, it is thought that particular ethnic groups (e.g. Asian women and women from a non-English speaking background) may be affected to a greater extent. This is possibly owing to cultural beliefs around depression, lack of integration and language barriers making it difficult to express difficulties in the postnatal period.
 
Many women will be emotional or experience mild mood changes in the first week after having a baby (referred to as the ‘baby blues’), but these feelings should be self-limiting.
 
In PND, these feelings last longer. Similar to depression, patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy. In addition, they may feel as though they are a bad parent, are unable to cope with their baby or may feel indifferent to their baby.
 
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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Lynparza (Olaparib) is indicated for treatment(s) of:

I. Ovarian Cancer
II. Metastatic Breast Cancer
III. Pancreatic cancer

a. I only
b. III only
c. I and II only
d. II and III only
e. All



Lynparza (Olaparib) is indicated for treatment(s) of:

I. Ovarian Cancer
II. Metastatic Breast Cancer
III. Pancreatic cancer

a. I only
b. III only
c. I and II only
d. II and III only
e. All

Answer: (e). All. Lynparza (Olaparib) is an inhibitor of the mammalian polyadenosine 5'-diphosphoribose polymerase (PARP) enzyme. Lynparza (Olaparib) tablets for oral administration contain 100 mg or 150 mg of Olaparib.

It is indicated for treatments of:
1. First-Line Maintenance Treatment Of BRCA-Mutated Advanced Ovarian Cancer
2. Maintenance Treatment Of Recurrent Ovarian Cancer
3. Advanced gBRCA-Mutated Ovarian Cancer After 3 Or More Lines Of Chemotherapy
4. Germline BRCA-Mutated HER2-Negative Metastatic Breast Cancer
5. Maintenance Treatment Of gBRCA-Mutated Pancreatic cancer

The recommended dose of Lynparza (Olaparib) is 300 mg (two 150 mg tablets) taken orally twice daily, with or without food, for a total daily dose of 600 mg.

Myelodysplastic Syndrome, Acute Myeloid Leukemia, Pneumonitis, fatigue, nausea, vomiting and fatal toxicity are reported side effects of drug.

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Ubrelvy (Ubrogepant) is indicated for the treatment of:

a. Hypertension
b. Migraine
c. Diabetes mellitus
d. Parkinsonism
e. Generalized anxiety




Ubrelvy (Ubrogepant) is indicated for the treatment of:

a. Hypertension
b. Migraine
c. Diabetes mellitus
d. Parkinsonism
e. Generalized anxiety

Answer: (b) Ubrelvy (Ubrogepant) is indicated for the acute treatment of migraine with or without aura in adults. It is the first and only orally-administered calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) for the treatment of migraine attacks once they start.

Ubrelvy (Ubrogepant) provided lasting relief up to 24 hours as well. It works in a new way by blocking CGRP, a protein that is released during a migraine attack, from binding to its receptors. It works without constricting blood vessels, which some older treatments are known to do. It is non-narcotic, not scheduled, and does not have addiction potential. It has been approved with two dose strengths, 50 mg and 100 mg.

The recommended dose is 50 to 100 mg by mouth for acute migraine. If needed, a patient may take second dose at least 2 hr after initial dose. Do not exceed 200 mg within 24 hours.

Safety of treating greater than 8 migraines/30-day period is not established.

Nausea, somnolence and dry mouth are currently reported side effects of the drug.

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Dayvigo (Lemborexant) is indicated for the treatment of insomnia. The probable mechanism of action of Dayvigo (Lemborexant) is:

a. benzodiazepine receptor agonist
b. benzodiazepine receptor antagonist
c. Melatonin receptor agonist
d. Orexin receptor antagonist
e. Histamine H2 receptor antagonist


Dayvigo (Lemborexant) is indicated for the treatment of insomnia. The probable mechanism of action of Dayvigo (Lemborexant) is:

a. benzodiazepine receptor agonist
b. benzodiazepine receptor antagonist
c. Melatonin receptor agonist
d. Orexin receptor antagonist
e. Histamine H2 receptor antagonist

Answer: (d) The active ingredient found in Dayvigo (Lemborexant) is Lemborexant. Each film coated tablet contains 5 mg or 10 mg of Lemborexant.

Dayvigo (Lemborexant) is indicated for the treatment of adult patients with insomnia, characterized by difficulties with sleep onset and/or sleep maintenance.

The recommended dosage of Dayvigo (Lemborexant) is 5 mg taken no more than once per night, immediately before going to bed, with at least 7 hours remaining before the planned time of awakening.

The dose may be increased to the maximum recommended dose of 10 mg based on clinical response and tolerability. Time to sleep onset may be delayed if taken with or soon after a meal.

The mechanism of action of Dayvigo (Lemborexant) in the treatment of insomnia is presumed to be through antagonism of orexin receptors. The orexin neuropeptide signaling system plays a role in wakefulness.

Blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R is thought to suppress wake drive. Dayvigo (Lemborexant) binds to orexin receptors OX1R and OX2R and acts as a competitive antagonist.

Somnolence, headache, fatigue and abnormal dreams are reported side effects of drug.


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Conjupri is the pharmacologically active enantiomer of:

a. Cyclosporine
b. Amlodipine
c. Pregabalin
d. Carbamazepine
e. Cisplatin




Conjupri is the pharmacologically active enantiomer of:

a. Cyclosporine
b. Amlodipine
c. Pregabalin
d. Carbamazepine
e. Cisplatin

Answer: (b) The active ingredient found in Conjupri is Levoamlodipine. It is the pharmacologically active enantiomer in Amlodipine (a racemic mixture of (R)- and (S)-Amlodipine), for the treatment of hypertension. Amlodipine is a third-generation calcium channel blocker first developed and marketed by Pfizer as Norvasc (Amlodipine besylate) tablets in 2.5 mg, 5.0 mg, and 10.0 mg in 1992. The approved Conjupri (Levoamlodipine maleate) tablets come in 1.25 mg, 2.5 mg and 5.0 mg.

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Avoid initiation or interrupt __________if absolute lymphocyte count is less than 500 cells/mm3, absolute neutrophil count is less than 1000 cells/mm3, or hemoglobin level is less than 8 g/dL.

a. Rheumatrex
b. Prograf
c. Rinvoq
d. Xcopri
e. Carboplatin


Avoid initiation or interrupt __________if absolute lymphocyte count is less than 500 cells/mm3, absolute neutrophil count is less than 1000 cells/mm3, or hemoglobin level is less than 8 g/dL.

a. Rheumatrex
b. Prograf
c. Rinvoq
d. Xcopri
e. Carboplatin

Answer: (c) Rinvoq (Upadacitinib) is a Janus kinase (JAK) inhibitor indicated for the treatment of adults with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate.

Use of Rinvoq (Upadacitinib) in combination with other JAK inhibitors, biologic DMARDs, or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended.

Rinvoq (Upadacitinib) may be used as monotherapy or in combination with methotrexate. The recommended dose of Rinvoq (Upadacitinib) is 15 mg once daily. It is available as extended release tablet form.

It should be used with caution in patients receiving chronic treatment with strong CYP3A4 inhibitors (e.g., ketoconazole). Coadministration of Rinvoq (Upadacitinib) with strong CYP3A4 inducers (e.g. rifampin) is not recommended.

Serious infections leading to hospitalization or death, including tuberculosis and bacterial, invasive fungal, viral, and other opportunistic infections, have occurred in patients receiving Rinvoq (Upadacitinib).

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Which of the following statements is NOT TRUE about Xeljanz?

a. It is a Janus kinase (JAK) inhibitor.
b. It is indicated for the treatment of ulcerative colitis.
c. The active ingredient found in Xeljanz is Tofacitinib.
d. It should always prescribe with Cyclosporine to increase its efficiency.
e. If a serious infection develops, interrupt Xeljanz/Xeljanz XR until the infection is controlled.


Which of the following statements is NOT TRUE about Xeljanz?

a. It is a Janus kinase (JAK) inhibitor.
b. It is indicated for the treatment of ulcerative colitis.
c. The active ingredient found in Xeljanz is Tofacitinib.
d. It should always prescribe with Cyclosporine to increase its efficiency.
e. If a serious infection develops, interrupt Xeljanz/Xeljanz XR until the infection is controlled.

Answer: (d) Use of Xeljanz/Xeljanz XR in combination with biologic DMARDs or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended.

The active ingredient found in Xeljanz is Tofacitinib. It is a Janus kinase (JAK) inhibitor. It is indicated for treatments of:
1. Rheumatoid Arthritis
2. Psoriatic Arthritis
3. Ulcerative Colitis

The recommended dose is 5 mg twice daily or 11 mg once daily. It can be taken with or without food. It is available in tablet and extended release tablet forms.

Do not initiate Xeljanz/Xeljanz XR in patients with an absolute lymphocyte count less than 500 cells/mm3, an absolute neutrophil count (ANC) less than 1000 cells/mm3 or who have hemoglobin levels less than 9 g/dL.

Patients treated with Xeljanz/Xeljanz XR are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt Xeljanz/Xeljanz XR until the infection is controlled.

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In which way is Tolsura (Itraconazole) different from Sporanox (Itraconazole)?

a. Different dosing frequency
b. Less side effects
c. Different indication
d. Different dosage form
e. No difference


In which way is Tolsura (Itraconazole) different from Sporanox (Itraconazole)?

a. Different dosing frequency
b. Less side effects
c. Different indication
d. Different dosage form
e. No difference

Answer: (c) different indication.

Tolsura (itraconazole capsules) and Sporanox (itraconazole) are azole antifungals used to treat different types of infections. Tolsura is used to treat blastomycosis, pulmonary and extrapulmonary; histoplasmosis, including chronic cavitary pulmonary disease and disseminated, non-meningeal histoplasmosis; and aspergillosis, pulmonary and extrapulmonary, in patients who are intolerant of or who are refractory to amphotericin B therapy.

Sporanox is used to treat fungal infections of the lungs, mouth or throat, toenails, or fingernails.

The dose of Tolsura to treat blastomycosis and histoplasmosis is 130 mg to 260 mg daily. The dose of Tolsura to treat aspergillosis is 130 mg to 260 mg daily.

Dosage of Sporanox depends upon the condition for which it is being used to treat.

Side effects of Tolsura and Sporanox that are similar include nausea, vomiting, skin rash, headache, diarrhea, itching, and dizziness.

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