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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. The risk of methemoglobinemia is highest with the use of:

A) benzocaine 20% topical cream in a 42-year-old for pain associated with insect bites.
B) benzocaine 6% topical cream in a 25-year-old for pain associated with a sunburn.
C) benzocaine 7.5% oral gel in an 18-month-old for oral pain associated with teething.
D) benzocaine 10% oral gel in a 67-year-old for oral pain associated with ill-fitting dentures.

2. A pharmacotherapy specialist is contemplating Writing a case report on a suspected penicillin induced neutropenia in a patient who received intravenous penicillin G for treatment of infective endocarditis. The specialist has established a temporal relationship between the period of medication administration and the onset of neutropenia, and has excluded other potential causes of the adverse effect.
Which of the following is the most appropriate next step in composing the case report?

A) Collect all pertinent patient information, including past medical history, laboratory data, medication history, and consent.
B) Describe the incidence, severity, and outcome of penicillin-induced neutropenia for the introduction section of the report.
C) Generate ideas and wording for the patient case summary portion of the report.
D) Perform a comprehensive literature search to identify existing literature describing neutropenia in penicillin-treated patients.

3. A patient presents with palpitations and shortness of breath. A 12-lead ECG reveals a regular narrow QRS complex supraventricular tachycardia. What is the recommended first-line therapy?

A) Adenosine
B) Verapamil
C) Amiodarone
D) Lidocaine

4. A physician suspects that a patient's symptoms are related to abrupt discontinuation of a certain drug and asks the pharmacotherapy specialist about common reactions in this type of situation.
A literature search produces one case report of a discontinuation syndrome involving the drug.
What is the most appropriate action to take with regard to the current suspected adverse event?

A) Report the event to the P & T Committee.
B) Report the event to the FDA MedWatch program.
C) Write and submit a case report detailing the event.
D) Complete a manufacturer's adverse event report.

5. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?

A) A pre-distribution digoxin concentration, which may be misinterpreted
B) A concentration within the desirable range
C) A post-distribution digoxin concentration, which indicates significant toxicity
D) Reflects the effect of furosemide on the renal excretion of digoxin

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