Chicago State University School of Pharmacy PHAR 6128 Pharmacy Patient Skills II
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Free Chicago State University School of Pharmacy PHAR 6128 Pharmacy Patient Skills II Questions
Which of the following options promotes the safe use of contact lenses?
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Contact lens storage cases should be replaced every 3 months
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Dispose of used contact solution daily
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Remove lenses prior to using ocular medications
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All of the above
Explanation
Correct Answer: D) All of the above
All three practices are essential components of safe contact lens use. Replacing storage cases every 3 months prevents bacterial biofilm buildup that can lead to serious eye infections. Disposing of used contact solution daily and never topping off old solution prevents microbial contamination. Removing lenses before applying ocular medications ensures proper drug absorption and prevents drug interactions with lens material. Together, these habits significantly reduce the risk of contact lens-related complications such as microbial keratitis.
Which of the following agents is most likely to cause sedating side effects?
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Fexofenadine
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Pseudoephedrine
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Diphenhydramine
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Loratadine
Explanation
Correct Answer: C) Diphenhydramine
Diphenhydramine is a first-generation antihistamine that readily crosses the blood-brain barrier, causing significant CNS depression and sedation. This is why it is also used as an OTC sleep aid. Fexofenadine and loratadine are second-generation antihistamines specifically designed to minimize CNS penetration and are considered non-sedating. Pseudoephedrine is a decongestant/stimulant that actually causes the opposite effect — CNS stimulation, insomnia, and increased alertness.
Patient NJ is a 35-year-old female who comes to your pharmacy complaining of new red, itchy, watery eyes that started as the weather began to change 1 week ago. She has allergy symptoms from time to time and takes a daily antihistamine. She tried GenTeal Tear Drops 3x a day, but had no success. Rubbing her eyes makes it worse. She states that her symptoms are mild and that this is not a daily occurrence. NJ has no known drug allergies and takes a multivitamin daily and loratadine 10 mg daily. Which of the following OTC options would you recommend to use for her intermittent symptoms?
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Theratears Gel® - CMC 1%, sodium bicarbonate
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Opticrom® - cromolyn sodium
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Refresh Tears® - carboxymethylcellulose 0.5%
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Opcon-A® - naphazoline 0.02675% and pheniramine 0.315%
Explanation
Correct Answer: D) Opcon-A® - naphazoline 0.02675% and pheniramine 0.315%
NJ's symptoms of red, itchy, watery eyes triggered by seasonal weather changes are consistent with allergic conjunctivitis, not dry eye disease. Plain lubricating drops like GenTeal and Refresh Tears failed because they do not address the allergic component. Opcon-A® combines naphazoline (a decongestant/vasoconstrictor to reduce redness) and pheniramine (an antihistamine to relieve itching), making it ideal for intermittent allergic eye symptoms. Cromolyn sodium (Opticrom®) is a mast cell stabilizer better suited for daily preventive use rather than intermittent relief.
DF is a 33-year-old male complaining of mild (pain score = 3) right ankle pain following an injury that occurred yesterday during his kickball game. DF reports mild inflammation and has some minor cuts and bruises in the affected area. DF reports an allergy to salicylates and has a medical history significant for chronic alcohol abuse (> 4 alcoholic beverages/day). Which of the following would be the BEST treatment option for DF's pain?
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Ibuprofen
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Acetaminophen
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Heat treatment
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Aspirin
Explanation
Correct Answer: C) Heat treatment
This patient has two critical contraindications that eliminate most pharmacologic options. Aspirin is contraindicated due to his salicylate allergy. Ibuprofen (an NSAID) is contraindicated because NSAIDs can worsen bleeding risk with open cuts and should be avoided with alcohol use. Acetaminophen is contraindicated with chronic heavy alcohol use (>3 drinks/day) due to the risk of severe hepatotoxicity. Heat treatment, while typically not preferred for acute injuries with inflammation, is the safest option given all pharmacologic choices are contraindicated in this patient.
What type of headache is classified by unilateral pulsating, throbbing pain that can last from hours to days?
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Sinus
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Migraine
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Aggravating
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Tension
Explanation
Correct Answer: B) Migraine
Migraines are characterized by unilateral (one-sided), pulsating, moderate to severe throbbing pain that typically lasts between 4 to 72 hours. They are often accompanied by nausea, vomiting, and sensitivity to light and sound. Tension headaches present as bilateral, band-like pressure pain. Sinus headaches are associated with facial pressure and congestion. "Aggravating" is not a headache type but rather a factor that worsens existing headaches.
Which of the following are therapeutic duplications?
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Lunesta 1 mg and Tylenol PM 500 mg/25 mg
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No Doz 200 mg tablets and melatonin ES 10 mg
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Unisom softgels 50 mg and Tylenol PM 500 mg/25 mg
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Unisom softgels 50 mg and melatonin ES 10 mg
Explanation
Correct Answer: C) Unisom softgels 50 mg and Tylenol PM 500 mg/25 mg
Unisom softgels contain diphenhydramine 50 mg, and Tylenol PM contains acetaminophen 500 mg combined with diphenhydramine 25 mg. Taking both together results in therapeutic duplication of diphenhydramine, an antihistamine used as a sleep aid, increasing the risk of adverse effects such as excessive sedation, anticholinergic effects, and toxicity. The other combinations involve agents with different mechanisms of action and do not constitute therapeutic duplication.
There are two questions associated with this case." "Insomnia-Fatigue Case 2."
A regular patron of the grocery store pharmacy comes to pick up his monthly refill for temazepam (Restoril), which is a long-acting benzodiazepine. He also wants to ring out a 4-pack of Corona Light and 4 sugar-free Red Bulls. He seems out of it — you ask him for his birthday multiple times and each time he gives you his address.
VS is a 56-year-old male complaining of mild left leg pain following a cycling accident that occurred yesterday. VS reports no inflammation, but he does have broken skin in the area secondary to cuts and scrapes from the accident. VS reports no drug allergies and has a medical history significant for impaired renal function. Which of the following would be the BEST treatment option for VS's pain?
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Heat Treatment
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Ibuprofen
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Naproxen
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Acetaminophen
Explanation
Correct Answer: D) Acetaminophen
This patient has impaired renal function, which is a contraindication for NSAIDs such as ibuprofen and naproxen, as these agents reduce renal prostaglandin synthesis, causing further vasoconstriction of renal vasculature and potentially worsening kidney function. Heat treatment is contraindicated given the presence of broken skin, cuts, and scrapes, as it could worsen inflammation and increase infection risk. Acetaminophen is renally safe at appropriate doses and has no contraindications in this patient, making it the best pharmacologic choice.
Which of the following causes of daytime sleepiness can be treated with self-care measures like drinking a Red Bull?
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Short-term, transient insomnia due to lifestyle changes
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Narcolepsy
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Restless leg syndrome
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Obstructive sleep apnea
Explanation
Correct Answer: A) Short-term, transient insomnia due to lifestyle changes
Daytime sleepiness resulting from short-term, transient insomnia caused by lifestyle factors such as jet lag, irregular sleep schedules, or temporary stress can be managed with self-care measures including caffeine-containing products like energy drinks. In contrast, narcolepsy, restless leg syndrome, and obstructive sleep apnea are all medical conditions requiring formal diagnosis and prescription or specialized treatment — caffeine would be insufficient and potentially harmful in managing these disorders.
Which of the following is the proper treatment strategy for medication-overuse headache?
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Increase the analgesic dose and frequency
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Abruptly discontinue offending agent
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No treatment is warranted, as the headache is self-limiting
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Taper and subsequently eliminate offending agent
Explanation
Correct Answer: D) Taper and subsequently eliminate offending agent
Medication-overuse headache (rebound headache) occurs when analgesics or other headache medications are used too frequently, paradoxically worsening headache frequency and severity. The correct treatment strategy is to gradually taper and then discontinue the offending agent rather than abruptly stopping, which can cause withdrawal symptoms and severe rebound effects. Increasing the dose would further worsen the condition, and the headache will not resolve on its own without addressing the medication overuse.
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