Many patients self-medicate with antacids. Which patients should be counseled not to take
calcium carbonate antacids without discussing it with their provider or a pharmacist first?
1. Patients with kidney stones
2. Pregnant patients
3. Patients with heartburn
4. Postmenopausal women - ANS1. Patients with kidney stones
Patients taking antacids should be educated regarding these drugs, including letting them know
that:
1. They may cause constipation or diarrhea
2. Many are high in sodium
3. They should separate antacids from other medications by 1 hour
4. All of the above - ANS4. All of the above
Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea.
Loperamide:
1- Can be given to patients of all ages, including infants and children, for viral gastroenteritis
2- Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
3- Is the treatment of choice for the diarrhea associated with E. coli 0157 4- May be used in
pregnancy and by lactating women - ANS2- Slows gastric motility and reduces fluid and
electrolyte loss from diarrhea
Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints.
Bismuth subsalicylate:
1. May lead to toxicity if taken with aspirin
2. Is contraindicated in children with flu-like illness
3. Has antimicrobial effects against bacterial and viral enteropathogens 4. All of the above -
ANS4. All of the above
Hannah will be traveling to Mexico with her church group over spring break to build houses. She
is concerned she may develop traveler's diarrhea. Advice includes following normal food and
water precautions as well as taking:
, 1. Loperamide four times a day throughout the trip
2. Bismuth subsalicylate with each meal and at bedtime
3. A prescription for diphenoxylate with atropine to use if she gets diarrhea
4. None of the above - ANS2. Bismuth subsalicylate with each meal and at bedtime
Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea,
vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less
than her last recorded weight. Besides IV fluids, her exam warrants the use of an antinausea
medication. Which of the following would be the appropriate drug to order for Josie?
Jim presents with complaints of "heartburn" that is minimally relieved with Tums (calcium
carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate
first-step therapy would be:
1. Omeprazole (Prilosec) twice a day
2. Ranitidine (Zantac) twice a day
3. Famotidine (Pepcid) once a day
4. Metoclopramide (Reglan) four times a day - ANS2. Ranitidine (Zantac) twice a day
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
1. Iron deficiency anemia, vitamin B12 and calcium deficiency
2. Folate and magnesium deficiency
3. Elevated uric acid levels leading to gout
4. Hypokalemia and hypocalcemia - ANS1. Iron deficiency anemia, vitamin B12 and calcium
deficiency
Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term
omeprazole use places her at increased risk for:
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet
changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice
of medication for a 10- year-old child would be:
1. PEG 3350 (Miralax)
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