Exam (elaborations)
FPGEE QUIZ QUESTIONS AND ANSWERS
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Exam of 59 pages for the course FPGEE at FPGEE (FPGEE QUIZ)
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FPGEE QUIZThe 2016 CDC guideline for prescribing opioids suggests to reassess the evidence of
"individual benefit and risk" when increasing daily dose to above ____ morphine
milligrams equivalent per day. - answer The 2016 CDC guideline for prescribing opioids
suggests to reassess the evidence of "individual benefit and risk" when increasing daily
dose to above 50 morphine milligrams equivalent per day, and avoidance of doses
greater than 90 MME per day.
A decrease in renal and liver function, as seen in the elderly, would prolong drug half-
life,_____________ plasma protein binding, and _____________volume of distribution.
- answer decrease
decrease
Which of the following are the two modifying factors that contribute to why women have
higher blood peak concentrations of alcohol than men when consuming equivalent
amounts? - answer women have higher fat content and less gastric alcohol
dehydrogenase (ADH)
what is the minimal effective concentration (MEC)? - answer the minimal drug plasma
concentration to produce effect
Fick's Law of Diffusion - answer diffusion through a membrane is directly proportional to
the surface area and concentration gradient and inversely proportional to the thickness
of the membrane and its resistance
acid-base reaction - answerreaction involving the transfer of a hydrogen ion between
reactant species
how to distinguish acids from bases:
-bases usually have OH and are bonded to a nonmetal
-acids usually bonded to metals and have a positive charge
Arrhenius acid - answerProduces H+ ions when dissolved in water
(proton donors)
strong acids ionize completely
weak acids dont ionize completely
the most common strong acids are:
hcl
,hbr
HI
HNO3 (nitric acid)
H2SO4
HClO4
weak acids:
HF
NH4+
Hc2H3O2 (acetic acid)
HCN
HNO2 (nitrous acid)
H2SO3
when dealing with oxy-acids, the acid that has more oxygen atoms will be the more
acidic one
LEWIS acids are electron acceptors
Arrhenius base - answerProduces OH- ions when dissolved in water
(proton acceptors)
strong bases: (soluble- form strong electrolytes)
KOH
NaOH
Ba(OH)2
weak bases:
Al(OH)3 -insoluble thus do not ionize well
NH3
F-
NO2-
C2H3O2-
LEWIS bases are electron donors
The principle of drug manipulation for excretion of a drug out of the renal tubule can be
accomplished by - answerAdjusting the urinary pH to ionize the drug
binding to plasma proteins - answeracidic drugs such as phenytoin bind to ALBUMIN
basic drugs such as lidocaine bind primarily to alpha1-acid glycoprotein(AAG)
bioavailability of a drug - answeris the amount of a drug absorbed per amount
administered
,for a generic drug to be bioeqivalent it must be measured in ____ of subjects to fall
within ____ of the mean of the test population bioavailability
(PER FDA) - answer80
20
Using the FDA bioequivalence rule, how much variation could a generic drug potentially
have from an innovator and still be considered equivalent? - answer40%
how much of oral morphine is metabolized on its first pass through the liver -
answer90%
ATSDR - answerAgency for Toxic Substances and Disease Registry; one of the DHHS
Operating Divisions.
DHHS (Department of Health and Human Services) - answerThe national agency that
deals with health in the United States.
SAMHSA - answerSubstance Abuse and Mental Health Administration; coordinates and
funds sustainable substance abuse and mental health programs in communities or
community health agencies
CBER - answerThe center for biological evaluation and research (CBER) ensures the
safety and efficacy o f blood products , vaccines, allergenics, biological therapeutics,
somatic cell therapy, gene therapy, and banked human tissue.
The center for food safety and applied Nutrition (CFSAN) established the CFSAN
adverse events reporting systems ( CAERS) in 2002 to identify potentially serious
problems secondary to the non-FDA approved herbs, minerals, vitamins, dietary
supplements, and other substances.
87. Which of the following are administered by Centers for Medicare & Medicaid
Services (CMS)? [Select ALL That Apply] a. Medicare
b. Medicaid
c. Clinical Laboratory Improvement Amendments (CLIA)
d. Children's Health Insurance Program (CHIP) - answerALL
Answer (a, b, c and d). The Centers for Medicare & Medicaid Services (CMS), a
component of the Department of Health and Human Services (HHS), administers
Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical
Laboratory Improvement Amendments (CLIA) and parts of the Affordable Care Act
(ACA.
86. Which of the following information is/are TRUE ABOUT Essential Fatty Acids?
[Select ALL That Apply]
a. Linoleic and alpha-linolenic are essential fatty acids.
, b. Arachidonic acid is classified as 'conditionally essential' fatty acid.
c. Ideally, in the diet, the ratio of omega-6 to omega-3 fatty acids should be between 1:1
and 4:1.
d. Excessive intake of omega-6 fatty acids can cause the deficiency of omega-3 fatty
acids. - answerALL
Answer (a, b, c and d). Essential fatty acids, or EFAs, are fatty acids that humans and
other animals must ingest because the body requires them for good health but cannot
synthesize them.
Only two fatty acids are known to be essential for humans: alpha-linolenic acid (an
omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid). Some other fatty acids are
sometimes classified as "conditionally essential," meaning that they can become
essential under some developmental or disease conditions; examples include
docosahexaenoic acid and gamma-linolenic acid.
It is not only important to incorporate good sources of omega-3 and omega-6s in a diet,
but also consume these fatty acids in the proper ratio. Omega-6 fatty acids compete
with omega-3 fatty acids for use in the body, and therefore excessive intake of omega-6
fatty acids can inhibit the use of omega-3 fatty acids by the body. Ideally, the ratio of
omega-6 to omega-3 fatty acids should be between 1:1 and 4:1. Instead, most
Americans consume these fatty acids at a ratio of omega-6: omega-3 between 10:1 and
25:1, and are consequently unable to reap the benefits of omega-3s. This imbalance is
due to a reliance on processed foods and oils, which are now common in the Western
diet. To combat this issue it is necessary to eat a low-fat diet with minimal processed
foods and with naturally occurring omega-3 fatty acids. A lower omega-6: omega-3 ratio
is desirable for reducing the risk of many chronic diseases.
Arachidonic acid is not one of the essential fatty acids. However, it does become
essential if there is a deficiency in linoleic acid or if there is an inability to convert linoleic
acid to arachidonic acid.
82. NABP reports a recent rise in forged prescriptions for Promethazine with Codeine.
Promethazine with codeine, a Schedule V CS, has been used for years as a cough
medication. Abusers commonly refer to it as:
a. Elixir of Heaven
b. Purple Drank
c. Orange Cocktail
d. Levoni's Drink - answerAnswer: Purple Drank.
"Purple drank" is a combination of promethazine with codeine mixed with a carbonated
soda, such as Sprite or Mountain Dew, and candy, such as crushed Jolly Ranchers,
mixed in for additional flavor.
what is PMP interconnect - answerI. InterConnect is comprehensive and thorough tool
for prescribers and dispensers to use in identifying potential opioid abuse.
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