Question

D. Lans c. Novolog d. Rosiglitazone 58. When administering a subcutaneous and/or intramuscular injection, you would gently pull back on the plunger to: a. Reduce discomfort to the patient b. Make sure that you are in the right site c. Make sure that you have the right medicine d. Ascertain that the needle is not in a blood vessel 59. Lantus Insulin is supplied as 100 units/Iml, and the bottle dispensed by the pharmacy contains 10ml of medication. Asmita has been instructed to inject 13 units qd subq. How many bottle(s) of Lantus will you need to call into the pharmacy for a 1-month (30 days) supply? 60. Humalog Insulin is supplied as 100 units/Iml and the bottle dispensed by the pharmacy contains 5ml of medication. Asmita has been instructed to inject 12 units tid pe subq. How many bottles of Humalog will you need to call into the pharmacy for a 1-month (30 days) supply? Case 8: Héctor, a 63-year-old male Subjective: • The patient presents today for acute abdominal pain • His pain started 3 days ago He is also experiencing nausea, dark-colored stools, and epigastric pain • He reports that he has been extremely stressed at work recently • He also reports a history of low back pain which he is self-managing He reports he is taking 800mg of ibuprofen every 4 hours He has been doing this for the past 2 weeks • Medications: Advil ibuprofen) 800mg, Inderal (propranolol) 40mg, Valium (diazepam) 2mg, Allegra (fexofenadine) 180 mg Objective: • RR 14, BP 135/85, HR 97, Temp 99.2 F Patient's abdominal exam is WNL other than vague discomfort • Patient's exam is negative for acute appendicitis Assessment & Plan • Gastric Ulcer O Pepcid (omeprazole) 40mg ER capsules: 1 cap po qd x8 weeks o Cytotec (misoprostol 200 mcg tablets: 1 tab po qid x8 weeks o Tylenol (acetaminophen) 325mg tablets: 1 tab po prn for pain, NTE 3,000 a day • Discontinue ibuprofen 61. What type of antiulcer agent is Prilosec (omeprazole)? a. Antacid b. H-receptor antagonist c. H -receptor antagonist d. Proton pump inhibitor 62. What type of bacteria is a common cause of gastric ulcers? a. Methicillin-resistant Staphylococcus aureus b. Clostridium difficile CROINS d. Helicobacter pylori 63. True or False: NSAID medications carry a black box warning for the development of gastrointestinal adverse events including bleeding, ulceration, and perforation a. True b. False 64. True or False: Cytotec can increase the absorption of medications such as tetracyclines, ranitidine, and ciprofloxacin a True b. False

Answer 1

58. Answer is: d. Ascertain that the needle i not in a blood vessel.

Because subcutaneous and intramuscular injection is intended to provide comparatively slow absorption into the systemic circulation, but if the injection is given directly to any blood vessels it may produce immediate effect. So it is important to confirm whether the needle goes to in subcutaneous layer or intramuscular and not in the blood vessels. Hence the needle is pulled back to check if any blood is coming in the needle or not.

59. Asmita has been instructed to inject 13 units of insulin qd. As qd means once a day, so total 13 unit she has to take every day. So for a month total number of unit she has to take will be calculated as:

13 x 30 = 390 unit in one month.

Lantus insulin of strength is 100 unit/ml and the volume of the bottle is 10 ml.

So, one bottle of lantus insulin contains total number of units of insulin is:

10 x 100 = 1000 units.

And total requirement for a month is 390 units, so one bottle of Lantus is sufficient for a 1 month dose.

Hence, the number of bottle will be 1 bottle.

50. Asmita has been instructed to inject 12 units of insulin tid. As tid means thrice a day, so total 12 x 3 = 36 unit she has to take every day. So for a month total number of unit she has to take will be calculated as:

36 x 30 = 1080 unit in one month.

Humalog insulin of strength is 100 unit/ml and the volume of the bottle is 5 ml.

So, one bottle of Humalog insulin contains total number of units of insulin is:

5 x 100 = 500 units.

And total requirement for a month is 1080 units, so the number of bottle required for 1 month supply will be calculated as:

1080/500 = 2.16

It means more than 2 bottle will be required. So, total 3 bottle of Humalog is needed to call into the pharmacy for a 1-month supply.

Hence, 3 bottle is required.

61. Answer is d. proton pump inhibitor

Omeprazole is a proton pump inhibitor that block the production of acid by the stomach.

62. Answer is d. Helicobacter pylori

63. Answer is a. True.

Because administration of NSAIDs induces the GIT problems like ulceration, bleeding and perforation.