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What is an elemental calcium amount in Actonel With Calcium?
 
a. 1250 mg
b. 500 mg
c. 650 mg
d. 1000 mg
e. 1250 mg


What is an elemental calcium amount in Actonel With Calcium?
 
a. 1250 mg
b. 500 mg
c. 650 mg
d. 1000 mg
e. 1250 mg
 
500 mg. Risedronate (Actonel) With Calcium is a co-package product containing Risedronate sodium tablets, 35 mg for once weekly dosing and calcium carbonate tablets, USP (1250 mg, equivalent to 500 mg elemental calcium) for daily dosing for the remaining 6 days of the week. Each package contains a 28-day course of therapy.
 
Risedronate (Actonel) is a pyridinyl bisphosphonate that inhibits osteoclast-mediated bone resorption and modulates bone metabolism. It is indicated for the treatment and prevention of osteoporosis in postmenopausal women.
 
Risedronate (Actonel) should be taken at least 30 minutes before the first food or drink of the day other than water. Risedronate (Actonel) should not be taken at the same time as other medications, including calcium.
 
To facilitate delivery to the stomach, Risedronate (Actonel) should be swallowed while the patient is in an upright position and with a full glass of plain water (6 to 8 oz). Patients should not lie down for 30 minutes after taking the medication.
 
Risedronate (Actonel) is not recommended for use in patients with severe renal impairment (creatinine clearance < 30 mL/min). No dosage adjustment is necessary in patients with a creatinine clearance ≥ 30 mL/min or in the elderly.
 
One 1250 mg calcium carbonate tablet (500 mg elemental calcium) orally, taken with food daily on each of the remaining six days (Days 2 through 7 of the 7-day treatment cycle).
 
Arthralgia, myalgia and nausea are commonly reported side effects of Risedronate (Actonel).

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Which of the following active ingredients found in Fosamax Plus D?
 
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4
e. Vitamin D5


Which of the following active ingredients found in Fosamax Plus D?
 
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4
e. Vitamin D5

Answer: (c) Alendronate sodium is a bisphosphonate that acts as a specific inhibitor of osteoclast mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.
 
Fosamax Plus D contains Alendronate sodium, a bisphosphonate, and Cholecalciferol (vitamin D3). Cholecalciferol (vitamin D3) is a secosterol that is the natural precursor of the calcium-regulating hormone calcitriol (1,25 dihydroxyvitamin D3).
 
It is indicated for the treatment of osteoporosis in postmenopausal women and to increase bone mass in men with osteoporosis.
 
The recommended dosage is one 70 mg Alendronate/2800 international units vitamin D3 or one 70 mg Alendronate/5600 international units vitamin D3 tablet once weekly.

Important Administration Instructions:

1. Take the drug at least one-half hour before the first food, beverage, or medication of the day with plain water only. Other beverages (including mineral water), food, and some medications are likely to reduce the absorption of Alendronate. Waiting less than 30 minutes, or taking Fosamax Plus D with food, beverages (other than plain water) or other medications will lessen the effect of Alendronate by decreasing its absorption into the body.

2. Take Fosamax Plus D upon arising for the day. To facilitate delivery to the stomach and thus reduce the potential for esophageal irritation, a Fosamax Plus D tablet should be swallowed with a full glass of water (6-8 ounces).

3. Patients should not lie down for at least 30 minutes and until after their first food of the day.

4. Fosamax Plus D should not be taken at bedtime or before arising for the day. Failure to follow these instructions may increase the risk of esophageal adverse experiences. 
 
Asthenia, diarrhea, abdominal pain, edema, leg cramps and rash are commonly reported side effects of Fosamax Plus D.

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Which of the following information is/are TRUE about Ebola Hemorrhagic Fever?
 
I. It is a viral hemorrhagic fevers.
II. It is a severe, often fatal disease in humans and nonhuman primates.
III. It is caused by infection with a virus of the family Filoviridae.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All


Which of the following information is/are TRUE about Ebola Hemorrhagic Fever?
 
I. It is a viral hemorrhagic fevers.
II. It is a severe, often fatal disease in humans and nonhuman primates.
III. It is caused by infection with a virus of the family Filoviridae.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All

Answer:(d), All. Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
 
Ebola HF is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. When infection occurs, symptoms usually begin abruptly. The first Ebolavirus species was discovered in 1976 in what the Democratic Republic of the Congo near the Ebola River is now. Since then, outbreaks have appeared sporadically.
 
There are five identified subspecies of Ebolavirus. Four of the five have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d'Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

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Which of the following information about Cardioviva is/are TRUE?
 
I. It is a natural, over-the-counter probiotic supplement.
II. It is clinically proven to support healthy knee cartilage in adults.
III. The probiotic strain in Cardioviva is Lactobacillus acidophilus.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All


Which of the following information about Cardioviva is/are TRUE?
 
I. It is a natural, over-the-counter probiotic supplement.
II. It is clinically proven to support healthy knee cartilage in adults.
III. The probiotic strain in Cardioviva is Lactobacillus acidophilus.
 
a. I only
b. I and II only
c. III only
d. II and III only
e. All
 
Answer: (a), I is true. Cardioviva is a natural, over-the-counter probiotic supplement. The probiotic strain in Cardioviva is Lactobacillus reuteri. It is clinically proven to support healthy Cholesterol levels in adults. The suggested dose is one 100 mg capsule twice daily with meals. Gas and bloating are commonly reported side effects of Cardioviva.
 
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Which of the following nasal corticosteroids is/are available OTC? [Select ALL THAT APPLY].
 
a. Nasacort
b. Nasonex
c. Omnaris
d. Flonase
e. Vancenase


Which of the following nasal corticosteroids is/are available OTC? [Select ALL THAT APPLY].
 
a. Nasacort
b. Nasonex
c. Omnaris
d. Flonase
e. Vancenase
 
Answer: (a,d),
 
The U.S. Food and Drug Administration (FDA) has approved Flonase Allergy Relief (fluticasone propionate 50 mcg spray)as an over-the-counter (OTC) treatment for temporary relief of the symptoms of hay fever or upper respiratory allergies.
 
Flonase Allergy Relief is the first over-the-counter nasal spray indicated for relief of all nasal and eye-related allergy symptoms including runny nose, sneezing, itchy nose, nasal congestion and itchy and watery eyes. Flonase Allergy Relief will be available at full prescription strength and to provide 24-hour non-drowsy allergy relief.
 
Nasacort Allergy 24HR and Children's Nasacort Allergy 24HR, an active ingredient Triamcinolone, are available as OTC for temporary relief of the symptoms of hay fever or upper respiratory allergies. The recommended dose is spray 2 (Triamcinolone acetonide 55 mcg spray) times into each nostril while sniffing gently daily. Once the allergy symptoms improve, reduce to 1 spray in  each nostril per day.

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Targiniq ER is an extended-release/long-acting (ER/LA) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Which of the following drugs provides abuse-deterrent property to Targiniq ER?
 
a. Oxycodone
b. Naltrexone
c. Naloxone
d. Methadone
e. Atropine


Targiniq ER is an extended-release/long-acting (ER/LA) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Which of the following drugs provides abuse-deterrent property to Targiniq ER?
 
a. Oxycodone
b. Naltrexone
c. Naloxone
d. Methadone
e. Atropine
 
Answer: (c) Naloxone. The active ingredients found in Targiniq ER are Oxycodone and Naloxone. It is an extended-release/long-acting (ER/LA) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
 
Targiniq ER has properties that are expected to deter, but not totally prevent, abuse of the drug by snorting and injection. When crushed and snorted, or crushed, dissolved and injected, the naloxone in Targiniq ER blocks the euphoric effects of oxycodone, making it less liked by abusers than oxycodone alone. Naloxone is a medication that is commonly used to reverse the effects of opioid overdose. Targiniq ER can still be abused, including when taken orally (by mouth), which is currently the most common way oxycodone is abused.
 
Constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain, anxiety, and sweating are commonly reported side effects of (Oxycodone + Naloxone) Targiniq ER.

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The U.S. Food and Drug Administration has approved Insulin Human Inhalation Powder, a rapid-acting inhaled insulin to improve glycemic control in adults with diabetes mellitus. It is available under the trade name:
 
a. Vazculep
b. Sivextro
c. Bunavail
d. Beleodaq
e. Afrezza


The U.S. Food and Drug Administration has approved Insulin Human Inhalation Powder, a rapid-acting inhaled insulin to improve glycemic control in adults with diabetes mellitus. It is available under the trade name:
 
a. Vazculep
b. Sivextro
c. Bunavail
d. Beleodaq
e. Afrezza
 
Answer: (e), Afrezza. The U.S. Food and Drug Administration has approved Afrezza (insulin human) Inhalation Powder, a rapid-acting inhaled insulin to improve glycemic control in adults with diabetes mellitus. Afrezza is available as single-use cartridges of (4 units, 8 units and 12 units).  
 
Afrezza is a rapid-acting inhaled insulin that is administered at the beginning of each meal.Afrezza should only be administered via oral inhalation using  the AFREZZA Inhaler. Afrezza is administered using a single inhalation per cartridge.
 
Afrezza is not a substitute for long-acting insulin. Afrezza must be used in combination with long-acting insulin in patients with type 1 diabetes, and it is not recommended for the treatment of diabetic ketoacidosis, or in patients who smoke.
 
Step 1: Starting Mealtime Dose:

1. Insulin Naïve Individuals: Start on 4 units of Afrezza at each meal.

2.  Individuals Using Subcutaneous Mealtime (Prandial) Insulin:  Determine the appropriate Afrezza dose for each meal by  converting from the injected dose using Figure 1.

3. Individuals Using Subcutaneous Pre-mixed Insulin: Estimate  the mealtime injected dose by dividing half of the total daily injected pre-mixed insulin dose equally among the three meals of the day. Convert each estimated injected mealtime dose to an appropriate Afrezza dose using Figure 1. Administer half of the total daily injected pre-mixed dose as an injected basal  insulin dose.


 
Afrezza has a Boxed Warning advising that acute bronchospasm has been observed in patients with asthma and chronic obstructive pulmonary disease (COPD). Afrezza should not be used in patients with chronic lung disease, such as asthma or COPD because of this risk.
 
The most common adverse reactions associated with Afrezza in clinical trials were hypoglycemia, cough, and throat pain or irritation.


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Which of the following information about Naloxone Auto-Injector (Evzio) is/are TRUE?
 
I. It is indicated for treating a suspected opioid overdose.
 
II. The principal advantage of Naloxone is that it doesn't cause withdrawal symptoms such as sweating, increased heart rate or agitation even in an opioid dependent patient.
 
III. A person should use great caution to administer Naloxone to someone who is not using opioids.
 
a. I only
b. I and II only
c. All
d. None of the above


Which of the following information about Naloxone Auto-Injector (Evzio) is/are TRUE?
 
I. It is indicated for treating a suspected opioid overdose.
 
II. The principal advantage of Naloxone is that it doesn't cause withdrawal symptoms such as sweating, increased heart rate or agitation even in an opioid dependent patient.
 
III. A person should use great caution to administer Naloxone to someone who is not using opioids.
 
a. I only
b. I and II only
c. All
d. None of the above

Answer: (a) I is True only. Naloxone HCL (Evzio) is a pre-filled, single-use auto-injector. Naloxone HCL (Evzio) is an opioid antagonist indicated for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression.
 
Naloxone HCL (Evzio) is intended for immediate administration as emergency therapy in settings where opioids may be present. It is for intramuscular and subcutaneous use only. Administer the initial dose of Naloxone HCL (Evzio) to adult or pediatric patients intramuscularly or subcutaneously into the anterolateral aspect of the thigh, through clothing if necessary. There's no harm in giving Naloxone HCL (Evzio) to someone who is not using opioids.
 
Naloxone HCL (Evzio) can trigger withdrawal symptoms such as sweating, increased heart rate, or agitation in the opioid dependent patient. Hypotension, hypertension, ventricular tachycardia and fibrillation, dyspnea, pulmonary edema, and cardiac arrest are commonly reported side effects of Naloxone HCl (Evzio).


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A pharmacist receives a new prescription to compound each capsule such a way so that it contains 200mg Acetaminophen, 50mg Butalbital and 40mg Caffeine. The final formulation of this compounded prescription shall be classified as:
 
a. Schedule III controlled drug
b. Schedule IV controlled drug
c. Schedule V controlled drug
d. Non-controlled substance


A pharmacist receives a new prescription to compound each capsule such a way so that it contains 200mg Acetaminophen, 50mg Butalbital and 40mg Caffeine. The final formulation of this compounded prescription shall be classified as:
 
a. Schedule III controlled drug
b. Schedule IV controlled drug
c. Schedule V controlled drug
d. Non-controlled substance

Answer (a): Schedule III controlled drug, [Section 811(g)(3)(A) Controlled Substances Act].

To be exempt from controlled substance requirement, the ratio of Acetaminophen to Butalbital is set to 70:15. In other words, for every 15mg Butalbital, there shall be at least 70 mg or more Acetaminophen required to exempt the formulation from controlled substance requirement.

In above prescription, the quantity of Butalbital is 50 mg; to exempt it from controlled substance requirement, we need to mix it with at least 233 mg or more Acetaminophen. The prescriber has requested Acetaminophen quantity to be set to 200mg; therefore the final formulation shall be classified as Schedule III controlled substance.

**Please note: Butalbital is classified as Schedule III controlled drug under the DEA. **
 
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Which of the following statements about methamphetamine is/are TRUE?
 
I. Methamphetamine is a highly addictive drug that can be manufactured in small and portable laboratories.

II. The use of methamphetamine can result in fatal kidney and lung disorders, brain damage, liver damage and blood clots.

III. Each pound of methamphetamine produced leaves behind five to six pounds of toxic waste.

IV. Children born to mothers who are abusers of methamphetamine can be born addicted and suffer birth defects, low birth weight, tremors, excessive crying, attention deficit disorder and behavior disorders.
 
a. I only
b. I and IV only
c. II only
d. All


Which of the following statements about methamphetamine is/are TRUE?
 
I. Methamphetamine is a highly addictive drug that can be manufactured in small and portable laboratories.

II. The use of methamphetamine can result in fatal kidney and lung disorders, brain damage, liver damage and blood clots.

III. Each pound of methamphetamine produced leaves behind five to six pounds of toxic waste.

IV. Children born to mothers who are abusers of methamphetamine can be born addicted and suffer birth defects, low birth weight, tremors, excessive crying, attention deficit disorder and behavior disorders.
 
a. I only
b. I and IV only
c. II only
d. All
 
Answer: (d) All. The illegal production and distribution of methamphetamine is an increasing problem nationwide. The methamphetamine is a highly addictive drug that can be manufactured in small and portable laboratories. These laboratories are operated by individuals who manufacture the drug in a clandestine and unsafe manner, often resulting in explosions and fires that can injure not only the individuals involved, but their families, neighbors, law-enforcement officers and firemen.
 
The use of methamphetamine can result in fatal kidney and lung disorders, brain damage, liver damage, blood clots, chronic depression, hallucinations, violent and aggressive behavior, malnutrition, disturbed personality development, deficient immune system and psychosis. Children born to mothers who are abusers of methamphetamine can be born addicted and suffer birth defects, low birth weight, tremors, excessive crying, attention deficit disorder and behavior disorders.
 
In addition to the physical consequences to an individual who uses methamphetamine, usage of the drug also produces an increase in automobile accidents, explosions and fires, increased criminal activity, increased medical costs due to emergency room visits, increases in domestic violence, increased spread of infectious diseases and a loss in worker productivity.
 
That environmental damage is another consequence of the methamphetamine epidemic. Each pound of methamphetamine produced leaves behind five to six pounds of toxic waste. Chemicals and byproducts that result from the manufacture of methamphetamine are often poured into plumbing systems, storm drains or directly onto the ground. Clean up of methamphetamine laboratories is extremely resource-intensive, with an average remediation cost of five thousand dollars.

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