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Last-381-Q 1
Last-381-Q 1
32- SE of Lithium:
headache, dry mouth, polydipsia, polyuria, polyphagia
may include ataxia, slurred speech, coarse tremors, confusion, and convulsions,
arrhythmia, hypotention & Teratogenicity with pregnant
33- Nurse give pt dose 2 hrs later what is the type of error:
wrong time errors - administration error
50- Nilotinib:
Tyrosine Kinase Inhibitor use as
chronic myelogenous leukemia (CML)
gastrointestinal stromal tumors (GISTs)
75- child receive high dose Amoxicillin for otitis and he has-
appointment for vaccine what we do shall we postponed
the vaccination ?: NO
76- child receive short acting b agonist without
improvement then he develop cough with wheeping what is
the treatment: a- Amoxicillin b- azithromycin
c- steroid
85- Baby with fever & tugging ear. Doctor exclude bacterial
infection : (amoxicillin with different doses + antiviral i do not remember)
= SQRT (.48555)
=.69681 m²
155- (Case) girl has epilepsy .. taking valproic acid and it's
control the disease she planned to be pregnant and she
already takes folic acid what to do:
a- shift from valproic acid to phenytoin b- keep her using valproic acid
c- give her leviteracetam and decrease valproic acid till epilepsy is well
controlled then discontinue
o Cyclizine
o Diphenhydramine (Benadryl)
o Dimenhydrinate (Gravol, Dramamine)
o Doxylamine
o Meclizine (Bonine, Antivert)
o Promethazine (Pentazine, Phenergan, Promacot) can be administered
o via a rectal suppository for adults and children over 2 years of age.
o Hydroxyzine
201- Pharmacoviglance :
Postapproval standing seientific and data gathering activities related to the
detection, assessment ,understanding and prevent s.e.
*Get emergency medical help if you have any of these signs of an allergic
reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or
throat.
*Remove the skin patch and call your doctor at once if you have any of these
serious side effects:
-Do not use this medication unless you are already being treated with a similar opioid
(narcotic) pain medicine and your body is tolerant to it.
-Do not expose the skin patch to heat while you are wearing it.
-Keep both used and unused fentanyl transdermal patches out of the reach of
children or pets. The amount of fentanyl in a used skin patch could be fatal to a child
or pet who accidentally sucks on or swallows the unit
***more infotmation about Use of Fentanyl Patches on this link***
https://www.palliativedrugs.com/download/08_09_Fentanyl%20Patches.pdf
214- "off label" meaning:
"Off-label" means the medication is being used in a manner not
specified in the FDA's approved packaging label (unapproved)
Source: http://reference.medscape.com/drug/brilinta-ticagrelor-999674
https://www.ncbi.nlm.nih.gov/pubmed/2507689
a- Amoxicillin b- Ciprofloxacin
c- Macrobid d- Ibuprofen
a- Septra b- Vancomycin
c- Ceftriaxone d- Clindamycin
a- Linzess b- Chlordiazepoxide
c- .Mechlorethamine d- Chlorhexidine
223-MOA of terazosin :
a- Increase nitous oxide b- Blocks alpha receptors
c- Blocks beta receptors d- Calcium channel blocker
224- pt have green sputum which anti cough can be give:
Guaifenesin such as robitussin , mucinex
229- girl came to the pharmacy with her brother drugs say
need same drugs:
a- Print prescription for her b- Send her to the doctor
Mild Hypothyroidism
1.7 mcg/kg or 100-125 mcg PO qDay; not to exceed 300 mcg/day
>50 years (or <50 yr with CV disease)
• Usual initial dose: 25-50 mcg/day
• May adjust dose by 12.5-25 mcg q6-8Week
>50 years with CV disease
• Usual initial dose: 12.5-25 mcg PO qDay
• May adjust dose by 12.5-25 mcg q4-6weeks until patient becomes euthyroid and serum
TSH concentration normalized; adjustments q6-8weeks also used
• Dose range: 100-125 mcg PO qDay
Severe Hypothyroidism
Initial: 12.5-25 mcg PO qDay
Adjust dose by 25 mcg/day q2-4Week PRN
Subclinical Hypothyroidism
Initial: 1 mcg/kg PO qDay may be adequate, OR
If replacement therapy not initiated, monitor patient annually for clinical status
243- Zolpidam max daily dose :
Immediate-release tablet, sublingual tablet, and oral spray
• Dosing for PO (Ambien), SL (Edluar), and oral spray (Zolpimist)
• Women: 5 mg PO/SL/oral spray qHS
• Men: Consider 5 mg PO/SL/oral spray qHS; may use 10 mg PO/SL/oral
spray qHS if needed
Extended-release (Ambien CR)
• Women: 6.25 mg PO qHS
• Men: Consider 6.25 mg PO qHS; may use 12.5 mg PO qHS; not to
exceed 12.5 mg/day
Source: http://reference.medscape.com/drug/ambien-cr-zolpidem-342931#0
NB q.h.s. = at bedtime
Lisinopril Contraindications
Hypersensitivity to lisinopril/other ACE inhibitors
History of ACE inhibitor-induced angioedema, hereditary or idiopathic angioedema
Coadministration of neprilysin inhibitors (eg, sacubitril)
Coadministration with aliskiren in patients with diabetes mellitus or with renal
impairment (ie, GFR <60 mL/min/1.73m²
http://reference.medscape.com/drug/prinivil-zestril-lisinopril-342321#5
It is known that mycophenolate products can cause birth defects in the unborn
baby of mothers who are, or have recently been, taking mycophenolate. It is for
this reason women are advised not to become pregnant whilst taking
mycophenolate and for 6 weeks after stopping.
source: Oxford Transplant Centre/Oxford Kidney Unit
There are three antidotes that have been used for MTX toxicity: leucovorin,
thymidine and glucarpidase.
Information
-Furosemide -ketoconazole -nifedipene -vastatine
-ator -apirin -sildenafil -celecoxib
Stop taking Metformin before the exam and not to begin using
it again until 48 hours after exam.
The goal for the emergent management of stroke is to assess the patient’s
airway, breathing, and circulation (ABCs); stabilize the patient as necessary;
and complete initial evaluation and assessment, including imaging and
laboratory studies, within 60 minutes of patient arrival . A Finnish study
demonstrated that time to treatment with fibrinolytics can be decreased
with changes in EMS and ED coordination and in ED procedures for treating
acute stroke patients.
https://emedicine.medscape.com/article/1916852-treatment#d10
1 ml ---------- 16 drops
y ml ---------- 1 drop
y = 1/16 = 0.0625 ml
1 gm ---------- 100 ml
x gm ---------- 0.0625 ml
x = 0.0625/100 = 0.000625 gm
= 625 µg
: مالحظة
نقطه16 = ملي1 ولذلك احنا حليناها علي ان.. ملي بيساوي كام نقطه1 في المسأله مكنش جايب
327- maximun infusion rate of vancomycin:
a- 1 ml/min b- 2 ml/min
c- 3 ml/min d- 4 ml/min
353- nurse received extra vial in the bag what should do:
a- keep until next dose b- return to pharmacy
a- it decrease excretion of Mg
b- it increase excretion of Mg
c-it decreases absorption of mg from intestine
Review the Medication Guide, prescription information, warning labels, and Drug
Facts Label with each new prescription or OTC product. Labeling may change as new
information is learned about medications, so it’s important to review the
information frequently.
a- methotrexate b- lithium
Information:
1- methotrexate is category X and it mean never use with mother and its danger to her live .
Second trimester – there continues to be a risk of congenital problems, but not to the same degree
360- Sulfasalazine:
antiinflammatory and immunosuppressive properties of 5-ASA, suggesting a
multifactorial basis of therapeutic action. These properties include:
• Immunosuppressive activity
• Aprepitant (Emend®)
• Dolasetron (Anzemet®)
363- Dose related SEs of 200 mM/L phynetoin:
a-Coma b- Nystagmus
c- Ataxia d- Decrease mental status
Voriconazole
Amphterocin_B
Cuspofungin
Important Notes
** List of High-Alert Medications **
Second Line :