Ques. Mr DL is a 69 year old male who is being treated for chronic cancer pain with 15 mg of SR morphine at 6 AM and 6 PM. He is complaining of significant breakthrough pain which wakes him up at about 4 AM and another pain 3 PM which requires rescue doses of immediate release morphine. His pain is well controlled throughout the rest of the day. How should morphine regimen should change:

A) Reduce the dose interval of SR morphine to q 8 h

B) No need to change, as rescue doses continue to be taken as needed

C) Increase the dose of immediate release morphine

D) Increase dose of SR morphine to 30 mg q 12 hours.

 

Answer: (d)

 

Ques. Which of the following counselling is important when a patient who has been given opioid for the first time:

A) Double of dose if needed

B) Do not drink alcohol while taking this medication

C) Take medication with full glass of water

D) Do not takes this medication with any other medication

 

Answer: (b)

 

Ques. Which of the following is most accurate description of breakthrough pain;

A) pain that is not responsive to medications

B) Pain that interrupts sleep

C) Pain that spikes upward in intensity

D) Pain experienced by cancer patients

 

Answer: (c)

 

Ques. JP is a 59-year-old male who is taking levodopa/benserazide 100/25 qid, selegiline 2.5 mg daily He has taken this medication at this dose for 3 months and has had little rigidity and posture.

Which of the following is true?

a) Levodopa/carbidopa is more effective than levodopa/benserazide, so JP should be switched to levodopa/carbidopa

b) Benserazide is administered with levodopa for the purpose of reducing the adverse effects of levodopa and decreasing levodopa

c) The lack of response to this agent means that JP does not have PD

d) None of the above

 

Answer: (b)

 

Ques. Which of the following is not a consequence of autonomic dysfunction in PD?

a) Urinary incontinence

b) Excessive sweating

c) Sleep disturbances

d) Sexual dysfunction

 

Answer: (c)

 

Ques. JP returned to the pharmacy with a new prescription of citalopram 50 mg daily for the treatment of depression symptoms. What is the pharmacist's concern?

A) drug and drug interaction

B) drug and food interaction

C) Age of patient

D) QT prolongation concern

E) no concern

 

Ques. JP reports excessive sweating, and hypertension is occurring from the past few days? What is the reason?

A) hypertension crisis

B) serotonin syndrome

C) Neuroleptic malignance

D) Drug side effects

E) Parkinson's disease symptoms