BASIC KNOWLEDGE FROM CLINICAL PHARMACY 1. Simple Choice . 2 2. Multiple Choice. 8 3. Grouping. 16 4. Relation Analysis . 18 5. Calculations . 22 6. Answer key. 24 BASIC KNOWLEDGE FROM CLINICAL PHARMACY 1 . S i m p l e C h o i c e
Choose the only one correct answer by solving the following problems. 1. A. Utilising the pharmacological, medico-biological knowledge of the pharmacist in order to improve the efficiency, safety, profitability and accuracy of therapy the patient is in the centre of interest. B. clinical pharmacy=good pharmacy practice C. aim of clinical pharmacy to estimate the morbidity rate of the population: processing the statistical data referring hereto. D. clinical pharmacy follows up the way of the ready prepared medicine before its absorption: namely examines the liberation of the active agent from the dosage form behaving as drug-release system. E. clinical pharmacy discipline is occupied with the optimal formulation of the Which one is not a typical work of clinical pharmacist? A. reporting and preventing the unexpected effects of the medicines. B. reporting and preventing the drug interactions. C. planning the total parenteral nutrition. D. planning the total enteral nutrition. E. controlling the diabetic patients and the anticoagulant therapy. Which one from the answers is not the aim of clinical pharmacy education? A. to train students in the clinical application of the basic theories of pharmacology B. to gain experiences in diagnosis and in special methods of patient care laying C. to get experiences in practical application of their analytical, pharmaceutical D. to express the capability of improving the mutual connection between patient and E. to improve – through pharmaceutical work – the health culture and health Which one of the following answers is not the drug information work of the clinical pharmacist? A. information to the physician B. information to the finance department C. information to the medical stuff D. information to the pharmacist E. information to the drug therapy committee BASIC KNOWLEDGE FROM CLINICAL PHARMACY Which activity is not included into the duties of clinical pharmacist? A. Supply with drugs the patients by their individual needs B. Contribution in the assessment of risk/benefit ration of the drug therapy for the C. responsible collaboration with members of health care team D. promote the cost/effective drug use E. participate in the toxicological evaluation of the drugs Characteristics of the bioequivalent preparations are: A. they are the same in manufacturing process, in active agents and auxiliary materials: but produced by different factories B. inter-individual fluctuations of the active agent concentrations are similar C. the plasma concentration curves are congruent D. they have the same effect, but they can’t be replaced for the patient without E. they bioavailability doesn’t differ from each other of differs only in insignificant Which is not object of patient’s counselling? A. name and strength of drug B. appropriate use of drug C. anamnesis of the patient’s disease D. the time of drug administration E. duration of the treatment Which answer is false? In case of drug interaction the previously or simultaneously given second pharmacon changes the medicine’s: A. biological transformation B. dosage form C. absorption D. excretion E. distribution Which one doesn’t belong to the therapy depending factors which influence the interaction? A. time of medicine intake B. the dose C. pharmacogenetical factors D. application way E. dosage form BASIC KNOWLEDGE FROM CLINICAL PHARMACY Which one of the following factors doesn’t influence the tissue distribution of a pharmacon? A. the affinity of the medicine to the tissues B. tissue blood-flow C. plasma-clearance D. the amount of the tissues Which one is not typical of rectal application form? A. absorption conditions are similar to G.I. tract’s B. if the pharmacon absorbs from the upper third part of the rectum it avoids the first C. the differently saturated rectum affects the bioavailability D. the general rules of non-ionic diffusion are valid A. it is the patient maximal co-operation with drug therapy B. it’s a summary of laboratory diagnostic data concerning to the patient C. it’s the patient’s notice about the side effects of the medicine D. the patient takes the physician’s orders into consideration and chooses those ones E. it’s a co-operation of the patient and the physician is determining the diagnosis and A. co-operation with the therapy B. psychological treatment of some illnesses C. when the patient doesn’t keep the physician’s advises D. strict control off medicine intake E. missing the medicine intake Which of the following factors can not be the result of non-compliance? A. misuse in the consequence of the cognitive disorder B. down or overdose by the patient C. dosage schedule mistake D. misunderstanding of the pharmacist counsel E. wrong time of administration A. consultation with GP B. establishment of the accurate diagnose C. choose of therapy D. consumption of OTC drugs E. duty of prescription BASIC KNOWLEDGE FROM CLINICAL PHARMACY A. safety, tolerance B. safety, efficiency C. safety, efficiency, interactions D. safety, interactions, dosing E. safety, interactions, new indications The self-controlled examination method is not suitable in case of: A. antimycotic agents B. antiarrithmic agents C. antihypertonic agents D. antidiabetics E. H2 receptor antagonists Where do we have to send the registration form of unexpected side effects in Hungary? A. to the Quality Control Department of the producing factory B. to the Ministry of Education C. to the Ministry of Welfare D. to the National Institute of Pharmacy E. to the National Institute of Public Health Can be teratogenic proved medicines used for human therapy. A. yes, after careful consideration of indication and beneficial risk B. no, compound which were proceed to be teratogenic during the chronic toxicological animal tests don’t come to the further human tests C. no, if it’s proved to be teratogenic in clinical phases it can be used only as D. no, if the teratogenic effect turns out after registration: it must be withdrawn from E. they can be used, but not in parenteral dosage form Which antibiotic causes damages in the haematopoietic organs: bone-marrow depression and platelet count decrease? A. erythromycin B. streptomycin C. oxytetracyclin D. chloramphenicol E. penamecyllin What is not the pharmacist’s role in drug information? A. producing an up-to-date database B. permanent observation of the suitable information source C. developing the drug therapy D. informing the physician E. consulting with the physician about all of the aspects of the drug therapy BASIC KNOWLEDGE FROM CLINICAL PHARMACY Nowadays in clinical nutrition should not take into consideration as ideal source of energy: A. aminoacids B. ethanol C. carbohydrates D. lipids E. dipeptides Which is the only one periodical which publishes only the contents of the periodicals? A. International Pharmaceutical Abstracts (IPA) B. Inpharma C. Index Medicus D. Current Contents E. Spectrum Pharmaceuticum What is not necessary written on label at the individual drug distribution in hospitals? A. drug’s name B. dosage C. patient’s name D. diagnose E. amount of the active ingredient The problems can be noticed by Therapeutic Drug Monitoring (TDM), except: A. side effects B. ineffectiveness C. interactions D. progression of disease E. non-compliance Advantage of the unit dose distribution system the follows, except: A. immediate distribution of the new ordering B. pharmaceutical control of the drug prescribing C. decrease of medication errors D. decrease in the cost of therapy E. pharmaceutical control of the individual drug distribution. Which could not be occurred as the consequence of the non-compliance? A. alteration in the result of the clinical investigations B. increase of cost C. loss of therapeutic success D. alteration in data of the clinical lab investigations E. increase in the duration of hospitalisation BASIC KNOWLEDGE FROM CLINICAL PHARMACY Which of the following factors does not determined the patient’s a response to the treatment? A. cause of the disease B. patient’s education level C. severity of the disease D. duration of the disease E. psychological status of the patient What is the aim of the phase III clinical trial? A. safety, tolerance B. safety, efficacy C. safety, efficacy, interactions D. safety, efficacy, dosing E. safety, interactions, new indications What is not pharmacist’s role in drug information? A. developing of databases B. permanent observation of the suitable information source C. developing the drug therapy D. informing the physicians E. informing the patients Which of the following does not accepted as a source of drug information? A. textbooks B. medical computer database C. pharmaceutical journals D. public literature E. handbooks, reviews Which is the accepted unit of drug consumption is the utilization studies? A. number of boxes B. unit price C. number of ampoules D. daily therapy cost E. Defined Daily Dose BASIC KNOWLEDGE FROM CLINICAL PHARMACY 2 . M u l t i p l e C h o i c e
The are more correct answers to the following questions/problems. Use the following letter: A only the 1st is correct B. only the 3rd is correct C. only the 1st and 5th answers are correct D. only the 2nd and 3rd answers are correct E. only the 2nd and 4th answers are correct 33. Choose the main functions of clinical pharmacy! 1. drug formulation 2. drug distribution 3. drug information 4. drug analysis 5. drug therapy analysis Choose the promoting factors of clinical pharmacy! 1. demand for drug information 2. development of pharmaceutical industry 3. appearance of selfmedication 4. national drug control 5. development of analytical methods What are the activity of clinical pharmacist 1. application of unit dose distribution system 2. drug research 3. drug storage 4. drug promotion 5. documentation of drug therapy What of the enzyme test value will be elevated in obstructive jaundice? 1. lactatedehydrogenase – LDH 2. alkalic - phosphatase – ALP 3. kreatinin - phosphokinase – CPK 4. aspartate-aminotransferase – ASA 4. acid - phosphatase – AcP Which of the following concepts belong to the drug therapy analysis? 1. expiry date 2. interactions 3. side effects 4. pharmacokinetic order of drug elimination 5. physico-chemical properties (disperse or coherence) of the drug formulation BASIC KNOWLEDGE FROM CLINICAL PHARMACY Choose those patient depending factors which influence the drug interactions? 1. the order of medicine intake 2. real function 3. pharmacogenetic factors 4. the time of medicine intake 5. plasma kreatinine level Which of the following do not belong to the efficiency decreasing interactions? 1. competitive antagonism 2. sensibilisation 3. functional antagonism 4. additive interaction Choose those factors which influence resorption of a medicine from the G.I. tract ! 1. nutrition 2. changes in the mucous membrane 3. form of the tablets 4. pH change 5. complex formation Chose those factors which hinder the absorption of a drug from the G.I. tract! 1. the drug forms a water soluble salt 2. the surrounding pH becomes unstable 3. there is a non-absorbent lipoid layer in front of the absorptive tissue 4. good diffusion in GI fluid at the place of absorption 5. high lipid solubility of the active ingredient Which mechanisms affect the rend secretion of a drug? 1. plasma clearance 2. active tubular secretion 3. passive glomerular filtration 4. renal clearance 5. passive reabsorption from the tubes High dosage of ascorbic acid could disturb the following clinical lab investigations in urine: 1. albumin 2. uric acid 3. sedimentation 4. glucose 5. homovalinic acid BASIC KNOWLEDGE FROM CLINICAL PHARMACY Choose the statements concerning monitoring systems! 1. it’s a non-invasive examination method 2. it’s centre is the National Institute of Pharmacy 3. it’s a drug observer program co-ordinated be WHO 4. it means following the tissue distribution of radio-labelled pharmacon 5. it means observation of the indication field and/or interactions of pharmaceutical Who/what is protected by Declaration of Helsinki? 1. physicians performing clinical trials 2. patent of investigational drugs 3. human rights of participant persons in clinical trials 4. scientific feature of clinical trials 5. economical interest of the manufacturer Which data is not important in the report of unexpected drug reaction? 1. all data are important 2. formulation (tablet, injection etc) of the problematic drug 3. dosage of the problematic drug 4. treatment duration of the problematic drug 5. the lot number of problematic drug Can be all of the side effects recognised during the preclinical and human I-II-III phases? 1. yes, because side effect are based on pharmacodynamic and pharmacokinetic 2. no, because some of side effects occur only after longer use than the duration of 3. no, because allergic reasons caused side effects are totally unexpected, they can’t be 4. yes, because these trials are performed on such a large number of volunteers that rarely occurring side effects get known too 5. no, because side effects caused by genetic reasons are clear up only during Which injuries don’t belong to the concept of „side effect” according to the WHO definition? 1. injuries occurring beside prescribed dosing 2. injuries caused by overdosing 3. damaged caused by a drug given because of therapeutic mistake 4. damages caused by drug allergy 5. damage as a result of drug abuses BASIC KNOWLEDGE FROM CLINICAL PHARMACY Which preparations increase the danger of thrombosis in case of simultaneous intake with coumarine derivatives? 1. noraminophenazone 2. barbiturate 3. rifampicine 4. chlordiazepoxide 5. cimetidine Which ones can be causes of intentional stopping of the medicinal treatment? 1. the patient’s forgetfulness 2. the patient feels better or he is symptomless 3. the character of the treatment 4. the patient is afraid of habituation 5. financial causes 1. alanine 2. fenil- alanine 3. methionine 4. alutamine 5. glycine Choose of reasons of non-compliance from the following factors! 1. absence of physical power 2. drug side effects 3. complex medicinal therapy 4. depression 5. high fever or unconsciousness 1. diet 2. drug therapy 3. working 4. physical exercise 5. consumption of alcohol What are not the sources of drug information? 1. literature dates, written data of seminars 2. manufacturers’ data, technical information 3. reports of research projects 4. databases, written publications 5. books, computer files BASIC KNOWLEDGE FROM CLINICAL PHARMACY Cytotoxic mixed infusions can be prepared by that persons, who: 1. is well informed about the pharmacological activity of the cytotoxic agents, the level of risk, and safety precautions and preventive methods of occupational health care 2. has middle level health education 3. has elevated level of specialisation 4. attended the course for poison- operator 5. is toxicological assistant Choose the statements concerning the clinical I phase trial! 1. its duration is from few months to 2 years 2. the aim in to determine the safe therapeutic human dose 3. subjects of the trial are usually healthy volunteers 4. the most important part of this phase in reporting the pharmacological effects 5. the pharmacokinetic and metabolism examination follow the drug intake, Choose the statement concerning the clinical IV. phase! 1. its duration is from 4 to 10 years 2. the drug can be registered and can be used widespreadly 3. subjects of this trials are healthy volunteers 4. there happens after registration that unknown indication field or interaction comes 5. the aim of kinetic trial is to determine the way of dosing Choose the drug(s) what needed potassium supplementation using in the therapy! 1. triamcinolone 2. triamterene 3. amiloride 4. digoxin 5. acetazolamide 20mg/day prednisolon treatment is not contraindicated in the following diseases: 1. herpes zooster 2. gout 3. ulcus duodeni 4. moderate high blood pressure 5. „sleeping” tuberculosis (proved by Ray) Choose the tasks of clinical pharmacist! 1. registration of drugs, which could influence the result of clinical lab investigations 2. documentation of treatment history 3. decision in therapeutic questions 4. monitoring of the adverse drug reactions 5. counselling in drug therapy BASIC KNOWLEDGE FROM CLINICAL PHARMACY Which committee has role in the clinical trial of drugs? 1. therapeutic committee 2. ethical committee 3. antibiotic committee 4. committee of economic affairs 5. committee for hygiene and epidemiology Choose patient-dependent factors of interaction! 1. order of drug administration 2. renal function 3. pharmacogenetic factors 4. time of drug administration 5. form of drug administration Light sensitisation can occur using the next drugs: 1. doxycyline 2. methotrexate 3. phenytoine 4. loratadine 5. thiaside Choose the drugs having interaction with cimetidine! 1. diazepame 2. phenylbutazone 3. salicylate 4. probenecide 5. oxprenolol What kind of evidences has to take into consideration for the definition of clinical importance and mechanism of drug interactions? 1. results of single dosage therapy in healthy volunteers can be escalated for the 2. the in vitro data could transfer very rarely to the in vivo relations 3. selective analytic methods should be used 4. change of drug plasma concentration is the result of the resorption differences 5. accurate diagnosis is essentially important 1. in acute toxicological studies the effect of few weeks administration will be 2. duration of chronic toxicological studies are lasting from 6 months till the end of 3. the results of acute toxicological studies will be expressed in LD50 values 4. the clinical trails of new drugs will be followed by series of toxicological studies 5. the chronic toxicological studies should be performed in rodents BASIC KNOWLEDGE FROM CLINICAL PHARMACY What does it mean „intensive monitoring system of adverse drug reactions”? 1. all of the postmarketing investigations accepted as a trial, therefore the most information can be achieved regarding the effects and side effects of the new drugs 2. in the course of the phase II-III. trials the efficacy of the new drugs have to be 3. the GP-s can report the unexpected to the national monitoring centre on a special 4. adverse drug monitoring system of WHO 5. the preclinical animal studies should be performed with the highest doses What issue is unnecessary in the report of an adverse drug reaction? 1. the geographical place of the adverse drug reaction 2. the formulation of the drug (injection, tablet, etc) 3. the applied dosage 4. duration of application 5. lot number of the drug Which statement are false regarding the alcohol consumption? 1. in the source of hepatic metabolisation aldehyd and acetate will be produced 2. hypnotic effect of nitrazepam will be reduced 3. co-administration with metronidazol vomiting, headache and tachycardia will be 4. blood sugar reducing effect of the glybencamid will be inhibited 5. status of the phenytoin treated epileptic patient will be worsened Vomiting is the important side effect of the following drugs: 1. cisplatin 2. propranolol 3. methoclopramide 4. captopril 5. adriamycine Which of the following reactions could not be the unwanted effect of digoxin therapy? 1. hypokalaemia 2. visual disturbance 3. ECG disturbance (ST wave) 4. gynecomastia 5. blood sugar elevation Which methods are suitable for compliance control? 1. drug treatment history 2. counting the retained tablets 3. therapeutic drug monitoring 4. ultrasound examinations 5. computerised prescription analysis BASIC KNOWLEDGE FROM CLINICAL PHARMACY What kind of anal complains can not be treated with OTC drugs? 1. itch 2. irritation feeling 3. bleeding 4. burning 5. pain Laxatives are not characterised by the next: 1. systemic absorption is minimal 2. duration of their effect 1-2 days 3. without or with a few of water should be take in 4. habituation can be excluded 5. indicated for the patients with diagnose: nodi haemorhoidales According to the result of the drug utilization studies you can not answer the following questions: 1. frequency of side effects 2. appropriateness of the high consumption 3. negligence of some drugs 4. drug consumption of special indication field 5. difference in the consumption of the in- and outpatients BASIC KNOWLEDGE FROM CLINICAL PHARMACY 3 . G r o u p i n g
Answer the following questions or solve the following problems by grouping the letter and number signed answers! 76. The equation express the measure of actual compliance in the percentage of the optimal one (100 %). The letters are the symbols of the factors of compliance. Please, find the meaning of them: 1. mistake number of the administration 2. ordered dosage number 3. relative compliance In the drug excretion process the rate of reabsorption, the relationship between the dissociated and un-dissociated components (degree of ionisation) for the week acids is described by the Hendersen-Hasselbach equation. Bind the letters of formula with the meanings seeing below! 1. urine concentration 2. plasma concentration 3. pH of urine 4. acidic dissociation constant 5. plasma pH The following equations concern to characteristic and behaviour of an iv. injection of a drug dissolved in co-solvent system. Group the letter signed parameters to the number signed specifications. 1. injection concentration 2. haematocrite 3. minimum blood flow rate 4. minimum plasma flow rate 5. drug solubility in plasma 6. infusion rate 7. plasma flow rate BASIC KNOWLEDGE FROM CLINICAL PHARMACY One of the most important rules of clinical pharmacist is collecting and processing information about drugs. This means summarising publications on drug efficiency, side effects, interactions etc. These are the phases of this work. Group the contents to the names of the phases! 1. title 2. summary 3. introduction 4. examination part 5. results 6. discussion 7. references A. writs about the used materials and method B. the total list of quitted literature sources C. gives a general information about of the content D. gives a short information about of the present state of the given field E. follows the list of authors’ workplace and gives further information about the F. discusses the result and points up how these contribute to complete the foregoing G. the authors write down the new results with suitable illustration. BASIC KNOWLEDGE FROM CLINICAL PHARMACY 4 . R e l a t i o n A n a l y s i s

The following sentences contain assertions and explanations. Choose the correct answer from the
five possibilities.
A. Both the assertion and the explanation are true and there is a causal connection between
B. Both the assertion and the explanation are true, but there is no causal connection between C. The assertion is true, but the explanation is not true D. The assertion is not true, but the explanation itself is true E. Both the assertion and the explanation are incorrect 80. Pharmacokinetic interactions can occur in all of the phamacokinetic phases, because the interfering active agents’ affect is synergetic or antagonistic in one receptor, one organ or in equivalent regulator system. Equivalent drug-combination causes serious side-effects at one patient, till these is no side effect at all at the other one, because the order of drug-intake considerably influence the therapeutic effect. Ototoxicity of aminoglicoside antibiotics is increased by simultaneously given sustained release diuretics, because these diuretics change the electrolyte composition of endolympha in the internal ear. Pharmacokinetic interactions are drug-specific in all of the cases, therefore these are predictable. Displacement from the plasmaprotein leads to clinical consequences, if it’s associated with renal or hepatic damage. Most of the drugs are weak electrolytes, therefore absorption of the weakly acidic drugs increases at lower pH: while at higher pH the absorption of weakly basic drug increases. Displacement from the plasmaprotein leads to clinical consequences only, if strongly proteinbinded drugs have wide therapeutic range. The special conditions where the interaction occurs between two drugs are often more important than the supposed importance of the interaction, because it’s very difficult to judge the clinical importance of drug interactions in case of one concrete patient. Displacement of a drug from the proteinbinded places can increase the concentration of the effective form, because the binding capacity is used up after the first drug intake, so the second drug doesn’t find free binding place therefore this one cumulates in the blood. BASIC KNOWLEDGE FROM CLINICAL PHARMACY There is no need for acute toxicity test in case of drugs used for general anaesthesia because it’s used in a single dose in humans. There are two effective compound compared to each other in parallel type group-controlled trials, because the perfect uniformity of the drug’s exterior is an important aspect. The clinical II. phase is the least critical is respect of dangers, because the easily measurable parameters of all vital functions must be controlled continuously during the trials In case of topical application form we can calculate with systematic effect too, because drugs applied on the mucous membranes of the eye-, nasal-, and facial cavities absorbing avoid the metabolisation effect of the liver. It’s a danger in case of group-allergy if the molecule structures of the two drugs are similar, because molecules metabolising to similar structure don’t cause group-allergy. Examining side effects occurring after registration, decomposition products originating during storage can be left out of consideration, because if the active agent decomposes its other effects necessary stop too. Instead of pharmacogenetic side effect causing drug an other drug with the same effect, but it’s metabolised by altering enzyme system can be given, because only drugs metabolised by deficient (polymorph) enzyme or enzyme-system cause pharmacogenetic side-effect. Most of our drugs are simple compound comparing to a protein molecule, and they are haptens from immunological point of view therefore they become antigenic the drug-protein bond is with weak physic-chemical forces. In case of strong drug-protein covalent bond, there can’t occur antigen causing sensibilisation. 97. All of orally applicable drugs are advised to take in half an hour before meals, because the food influence the absorption of the active agent. Formulation is practically neglectable from the standpoint of side-effects, because the main active agent is responsible for the side effects. The active agent liberates equally from intramuscular injection absorption is total because the active agent precipitates and forms a depot at the tissue pH. Cytostatics influence the laboratory results: namely the serum uric acid level increases, because secondary hyperuricaemia is inducted by fast neoplastic cell lysis. The serumprotein level increases during anticoncipient intake, because transferrin is synthesised in an increased degree. During catecholamine determination the metabolite of methyldopa is measured together with noradrenaline, therefore a high value is showed as they are similar in their chemical characteristics. BASIC KNOWLEDGE FROM CLINICAL PHARMACY Auxially materials used at drug-formulation can influence the laboratory tests: for example the colouring matter of levodopa (Dopaflex®) tablet-coat, because the protein bound iodine value increases. Labelling has no importance in compliance, because the physician or pharmacist tells the information concerning medicine to the patient in details. Patient counselling is the simplest way in order to improve the compliance, because patient’s collaboration is determined by the intelligence level. Non-compliance value is extremely negligible, because 98 % of the patients correctly follow the physician’s advises. Keeping the drug intake is a matter of obedience, because the patients are individuals. The value of fixed drug-combinations is well defined because in these cases the synergetic effects of two or more drugs are used up. Patient-compliance can be proved by supplementary labelling of the medicine, because with these the patient gets complete written in formation about the drug. All of the waste material produced in preparation of cytotoxic mixed infusions must collected in special way, because those has hazard for contamination. Cytostatic drug are dangerous for the treated patients in the consequence of their side effects, however the cytostatic infusions are hazardous also for personnel because of the accidental contamination. The pregnant women, breastfeeding mothers and young adults are forbidden in handling of cytostatic drugs, because these materials have not only cytostatic effect, but they could alter the genetic information of the human cells. The mixed infusions are magistral drug preparation, therefore their appropriate manufacturing is a pharmacist task. The role of a parenteral mixture is the feeding, it is not a vehicle for other drugs, therefore it is correct to mixed drugs in the solution. The optimal procedure of mixture is the result experimental work, because the components have to follow each other by a fixed order. The mixed infusions prepared in the pharmacy are contaminated mostly with fungi, but on ward prepared infusion mixtures could be infected with Gram negative bacteria. Therapeutic Outcome Monitoring (TOM) is the important part of pharmaceutical care and its basic purpose is to improve the patient’s quality of life. Optimisation of drug use by the pharmacist contribution improves the therapeutic outcome and patient’s quality of life, however it means also cost-reduction. BASIC KNOWLEDGE FROM CLINICAL PHARMACY Non-compliance is independent from the age, gender, education level, social position, personal character of the patient, because the GP-s have not forecast regarding to the habits of the drug intake. The cefalosporins are nephrotoxic drugs, because they have N-methyl-thiomethyl-tetrazol side chain. The polyol solutions are not optimal for the penicillin infusions, because their antimicrobial activity will be reduced by the ester formation. The physiological circadian rhythm can be changed by the drugs, because every exogene corticosteroide inhibit the normal endogene secretion. The optimal infusion mixture has as many as possible number of components, because
the microbial contamination can be avoid by this way.
The DDD value of captopril is 50 mg. How many DDD of captopril are present in a package of Capoten 12,5 mg tablets 30x? The recommended dose of cisplatin in monotherapy of cervix carcinome is 100 mg/m2. The body surface of the patient is 1,54 m2. How many ampoules are necessary for her from the Platidiam injection 25 mg? Maximal dose of cyclosporin A in psoriasis is 5 mg/kg. How many 50 mg capsules are the daily dose for a man with 96 kg body weight? The daily dose of isotretinoine is 0,3 mg/kg. How many capsules of Roaccutne 20 mg capsule are needed for a man weight 75 kg body weight? The energy content of glucose in 375 kcal/100 g. The optimal carbohydrate dose in total parenteral nutrition is 1800 kcal/day. How many ml of 20 % glucose infusion should be administered for patient? BASIC KNOWLEDGE FROM CLINICAL PHARMACY The prescribed dose of ampicilline for a patient 500 mg/6 hours. How many capsules are the daily need of 250 mg form of drug? Daily need of vitamin B1 is 10 mg. How many ml of the 5 % injection should be take into the parenteral nutrition mixture? Our patient with 83 kg body weight got 500 ml 10 % aminoacid infusion. What was his dosage expressed in mg/kg value? The paediatric daily dose of aminoacids are at least 2 g/kg. How many ml of 15 % aminoacid solution can be given for a 25 kg child? Gentamicin dose: 5 mg/kg. A 75 kg patient is treated by traditional regime: he will be injected 3 times/day. How many ml will be his single dose from the 40 mg/vial gentamicin injection? BASIC KNOWLEDGE FROM CLINICAL PHARMACY 6 . A n s w e r k e y

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Building a Database of Developmental Neurotoxicants: Evidence from Human and Animal Studies W. Mundy1 , S. Padilla1 , T. Shafer1, M. Gilbert1 , J. Breier1,2, J. Cowden1, K. Crofton1 , D. Herr1, K. Jensen1, K. Raffaele3 , N. Radio4, and K. Schumacher5. 1Neurotoxicology Div. U.S. EPA, RTP, NC 27711; 2Curriculum in Toxicology, Univ. of N.C. at Chapel Hill, Chapel Hill, NC, 2751


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