Question 46
The results of a drug-use evaluation study by the P & T Committee reveal that 15 prescribers are using an antibiotic inappropriately. Which of the following is the most effective strategy for improving the drug therapy?
Question 47
A 53-year-old patient is admitted to the hospital with diarrhea. He has been experiencing five unformed stools daily for 2 days. The patient had a previous admission 6 weeks ago for C.
difficile diarrhea, which was treated successfully with oral metronidazole. Stool tests are again positive for C. difficile toxin A.
On presentation, his vital signs are: BP 128/86 mm Hg, HR 75 bpm, RR 14 bpm, and T37.8°C.
WBC count shows 12,300 cells/ul (80% neutrophils-segs, 10% neutrophils-bands), serum creatinine 1.2 mg/dL, and albumin 3.4 g/dL. The patient has no evidence of colitis, toxic megacolon, or perforation on imaging studies of the abdomen.
What is the most appropriate treatment recommendation for this patient?
difficile diarrhea, which was treated successfully with oral metronidazole. Stool tests are again positive for C. difficile toxin A.
On presentation, his vital signs are: BP 128/86 mm Hg, HR 75 bpm, RR 14 bpm, and T37.8°C.
WBC count shows 12,300 cells/ul (80% neutrophils-segs, 10% neutrophils-bands), serum creatinine 1.2 mg/dL, and albumin 3.4 g/dL. The patient has no evidence of colitis, toxic megacolon, or perforation on imaging studies of the abdomen.
What is the most appropriate treatment recommendation for this patient?
Question 48
A patient asks for advice relative to an herbal supplement to treat heart failure. The patient is currently NYHA Class III (LVEF 25%) and is adherent to medications, which include digoxin
0.25 mg daily, furosemide 40 mg daily, lisinopril 10 mg daily, carvedilol 6.25 mg twice daily, potassium 20 mEq daily, and simvastatin 40 mg nightly.
The patient has BP of 120/78 mm Hg, HR of 60 bpm, 9 cm JVD, 2+ pitting edema, and has experienced a 2.3 kg weight gain in last 2 days. All laboratory values are within normal limits.
Based on the following information, what is the most appropriate suggestion for the patient?
0.25 mg daily, furosemide 40 mg daily, lisinopril 10 mg daily, carvedilol 6.25 mg twice daily, potassium 20 mEq daily, and simvastatin 40 mg nightly.
The patient has BP of 120/78 mm Hg, HR of 60 bpm, 9 cm JVD, 2+ pitting edema, and has experienced a 2.3 kg weight gain in last 2 days. All laboratory values are within normal limits.
Based on the following information, what is the most appropriate suggestion for the patient?
Question 49
Initial efficacy data on an experimental drug in the United States are usually collected in:
Question 50
A 76-year-old man has his first visit with a pharmacotherapy specialist for the management of his anticoagulation. The patient states that he started warfarin last week as instructed by his physician. He is able to explain the reason that he was started on anticoagulation therapy.
During the interview, some of the specialist's questions go unanswered or are answered inappropriately. For example, when asked if he has had any bleeding, the patient states that his breathing is fine.
Which will most likely be a barrier to the effective education of this patient?
During the interview, some of the specialist's questions go unanswered or are answered inappropriately. For example, when asked if he has had any bleeding, the patient states that his breathing is fine.
Which will most likely be a barrier to the effective education of this patient?