Question
Question 1 1 / 1 point
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
Question options:
A need to monitor drugs metabolized by 2D6 for toxicity
Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
Decreased conversion of codeine to morphine by CYP 2D6
The need for lowered dosages of drugs, such as beta blockers
Question 2 1 / 1 point
Rifampin is a nonspecific CYP450 inducer that may:
Question options:
Lead to toxic levels of rifampin and must be monitored closely
Cause toxic levels of drugs, such as oral contraceptives, when coadministered
Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
Cause nonspecific changes in drug metabolism
Question 3 1 / 1 point
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
Question options:
Decreased therapeutic levels of quinidine
Increased therapeutic levels of quinidine
Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
Increased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
Question 4 1 / 1 point
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
Question options:
Toxic levels of warfarin building up
Decreased response to warfarin
Increased risk for significant drug interactions with warfarin
Less risk of drug interactions with warfarin
Question 5 1 / 1 point
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
Question options:
Erythromycin
Digoxin
Cetuximab
Rifampin
Question 6 1 / 1 point
Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
Question options:
Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502 allele
Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 Allele
Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine
Question 7 1 / 1 point
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
Question options:
Decreased effectiveness of irinotecan in the treatment of cancer
Increased adverse drug reactions, such as neutropenia
Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
Increased concerns for irinotecan being carcinogenic
Question 8 1 / 1 point
A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.
Question options:
10
5
38
70
Question 9 1 / 1 point
A potential harmful effect on patients who take some herbal medication is:
Question options:
Constipation
Lead poisoning
Diarrhea
Life-threatening rash
Question 10 1 / 1 point
A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
Question options:
Coumadin, which may lead to bleeding problems
Coumarin, which can cause liver and kidney damage
Cinnamic aldehyde, which is toxic to the kidney
Cinnamate eugenol, which is toxic to the liver
Question 11 1 / 1 point
Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe:
Question options:
Herbs which are yang in nature
Herbs that are yin in nature
Ginger
Golden seal
Question 12 1 / 1 point
According to traditional Chinese medicine, if a person who has a fever is given a herb that is yang in nature, such as golden seal, the patient’s illness will:
Question options:
Get worse
Get better
Not be adequately treated
Need additional herbs to treat the yang
Question 13 1 / 1 point
In Ayurvedic medicine, treatment is based on the patient’s dominant dosha, which is referred to as the person’s:
Question options:
Vata
Pitta
Kapha
Prakriti
Question 14 1 / 1 point
When melatonin is used to induce sleep, the recommendation is that the patient:
Question options:
Take 10 mg 30 minutes before bed nightly
Take 1 to 5 mg 30 minutes before bed nightly
Not take melatonin more than three nights a week
Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Question 15 1 / 1 point
In the United States, over-the-counter drugs are regulated by:
Question options:
No one. There is no oversight for over-the-counter medications.
The U.S. Food and Drug Administration Center for Drug Evaluation and Research
The U.S. Drug Enforcement Administration
MedWatch
Question 16 1 / 1 point
As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
Question options:
Get a new patent for the over-the-counter form of the drug
Lower the costs because most prescription benefit plans do not cover generics
Market the drug to a whole new population, as they are able to market to patients instead of just providers
Continue to make large profits from their blockbuster brand-name drug
Question 17 1 / 1 point
The ailment that generates the greatest over-the-counter annual drug sales is:
Question options:
Constipation
Cough and colds
Heartburn
Acute and chronic pain
Question 18 1 / 1 point
Common over-the-counter pain relievers such as acetaminophen or ibuprofen:
Question options:
Are always safer for the patient than prescription pain medication
Are harmful if taken in higher than recommended amounts
Have minimal interaction with prescription medications
Should never be given to children unless recommended by their provider
Question 19 1 / 1 point
When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
Question options:
His appropriately only telling you about his regularly prescribed medications
His hiding information regarding his inappropriate use of aspirin from you
A common misconception that intermittently taken over-the counter medications are not an important part of his drug history
A common misuse of over-the-counter aspirin
Question 20 1 / 1 point
Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must:
Question options:
Be safe and labeled for appropriate use
Have a low potential for abuse or misuse
Be taken for a condition the patient can reliably self-diagnose
All of the above
Question 1 1 / 1 point
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
Question options:
A need to monitor drugs metabolized by 2D6 for toxicity
Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
Decreased conversion of codeine to morphine by CYP 2D6
The need for lowered dosages of drugs, such as beta blockers
Question 2 1 / 1 point
Rifampin is a nonspecific CYP450 inducer that may:
Question options:
Lead to toxic levels of rifampin and must be monitored closely
Cause toxic levels of drugs, such as oral contraceptives, when coadministered
Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
Cause nonspecific changes in drug metabolism
Question 3 1 / 1 point
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
Question options:
Decreased therapeutic levels of quinidine
Increased therapeutic levels of quinidine
Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
Increased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
Question 4 1 / 1 point
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
Question options:
Toxic levels of warfarin building up
Decreased response to warfarin
Increased risk for significant drug interactions with warfarin
Less risk of drug interactions with warfarin
Question 5 1 / 1 point
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
Question options:
Erythromycin
Digoxin
Cetuximab
Rifampin
Question 6 1 / 1 point
Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
Question options:
Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502 allele
Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 Allele
Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine
Question 7 1 / 1 point
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
Question options:
Decreased effectiveness of irinotecan in the treatment of cancer
Increased adverse drug reactions, such as neutropenia
Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
Increased concerns for irinotecan being carcinogenic
Question 8 1 / 1 point
A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.
Question options:
10
5
38
70
Question 9 1 / 1 point
A potential harmful effect on patients who take some herbal medication is:
Question options:
Constipation
Lead poisoning
Diarrhea
Life-threatening rash
Question 10 1 / 1 point
A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
Question options:
Coumadin, which may lead to bleeding problems
Coumarin, which can cause liver and kidney damage
Cinnamic aldehyde, which is toxic to the kidney
Cinnamate eugenol, which is toxic to the liver
Question 11 1 / 1 point
Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe:
Question options:
Herbs which are yang in nature
Herbs that are yin in nature
Ginger
Golden seal
Question 12 1 / 1 point
According to traditional Chinese medicine, if a person who has a fever is given a herb that is yang in nature, such as golden seal, the patient’s illness will:
Question options:
Get worse
Get better
Not be adequately treated
Need additional herbs to treat the yang
Question 13 1 / 1 point
In Ayurvedic medicine, treatment is based on the patient’s dominant dosha, which is referred to as the person’s:
Question options:
Vata
Pitta
Kapha
Prakriti
Question 14 1 / 1 point
When melatonin is used to induce sleep, the recommendation is that the patient:
Question options:
Take 10 mg 30 minutes before bed nightly
Take 1 to 5 mg 30 minutes before bed nightly
Not take melatonin more than three nights a week
Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Question 15 1 / 1 point
In the United States, over-the-counter drugs are regulated by:
Question options:
No one. There is no oversight for over-the-counter medications.
The U.S. Food and Drug Administration Center for Drug Evaluation and Research
The U.S. Drug Enforcement Administration
MedWatch
Question 16 1 / 1 point
As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:
Question options:
Get a new patent for the over-the-counter form of the drug
Lower the costs because most prescription benefit plans do not cover generics
Market the drug to a whole new population, as they are able to market to patients instead of just providers
Continue to make large profits from their blockbuster brand-name drug
Question 17 1 / 1 point
The ailment that generates the greatest over-the-counter annual drug sales is:
Question options:
Constipation
Cough and colds
Heartburn
Acute and chronic pain
Question 18 1 / 1 point
Common over-the-counter pain relievers such as acetaminophen or ibuprofen:
Question options:
Are always safer for the patient than prescription pain medication
Are harmful if taken in higher than recommended amounts
Have minimal interaction with prescription medications
Should never be given to children unless recommended by their provider
Question 19 1 / 1 point
When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:
Question options:
His appropriately only telling you about his regularly prescribed medications
His hiding information regarding his inappropriate use of aspirin from you
A common misconception that intermittently taken over-the counter medications are not an important part of his drug history
A common misuse of over-the-counter aspirin
Question 20 1 / 1 point
Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must:
Question options:
Be safe and labeled for appropriate use
Have a low potential for abuse or misuse
Be taken for a condition the patient can reliably self-diagnose
All of the above
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