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