Basic Hospital Pharmacy Practice Quiz

Answer: A single "serving" of a drug, e.g., a tablet or a teaspoon-sized dose of an oral liquid

Dispensing a single dose of a drug for a specific patient is one of many methods that hospital pharmacies use to prevent medication errors. Having bulk containers of medication on the nursing floor could lead to overdoses, or to the nurse selecting the wrong container. Each unit dose should be clearly labelled with the name of the drug, its strength (e.g., number of milligrams), its form (e.g., tablet or oral suspension), manufacturer, lot number, and expiration date.

Answer: The vial of epoetin alfa

Epoetin alfa (marketed under the brand names Epogen and Procrit) stimulates red blood cell production in the body. Like other colony-stimulating factors, it should not be sent through a pneumatic tube system, as its potency may be affected. Epoetin alfa should be stored in the refrigerator.

Answer: All of these are advantages

The ADM is just one of a multitude of ways in which technology benefits health care and pharmacy. Many hospital pharmacies have robots that use a barcode system to "pick" the right medications for the hospital's inpatients.

Answer: Total Parenteral Nutrition

Total Parenteral Nutrition provides the body's nutritional needs to patients whose digestive systems cannot process food. Hospital pharmacies prepare specialized, patient-specific mixtures of fats, carbohydrates, vitamins, and minerals for intravenous infusion - the nutrients go directly into the bloodstream. ("Parenteral" means "beyond the intestines.")

Answer: Ipratropium bromide

Ipratropium is a bronchodilator (it opens the airway to help the patient breathe).

Answer: Metoprolol succinate

In the case of metoprolol (a beta-blocker used mainly to treat high blood pressure), the drug's salt determines whether it is immediate-release or extended-release. (A drug's "salt" is the funny chemical name you often see after the drug's name. Some examples of salts are chloride, calcium, axetil, bitartrate, sodium, and many, many others.)

The metoprolol injection could not have been extended-release, because injection is basically the fastest method of getting a drug into the bloodstream. Metoprolol succinate (brand name: Toprol XL) is the extended-release version, and metoprolol tartrate (brand name: Lopressor) is immediate-release.

Answer: Senna liquid

Senna is a natural laxative (always given orally), and therefore very unlikely to be administered during surgery. The other drugs are all used regularly in the operating room.

Answer: Return it to the pharmacy for proper disposal

Poractant alfa (brand name: Curosurf) is used to treat RDS (Respiratory Distress Syndrome) in infants. It should be stored in the refrigerator. Since we have no way of knowing for sure how long it was out of the fridge, we have to assume for safety's sake that its integrity has been compromised, and it should be disposed of.

It is also a good idea to make sure that there is still enough Curosurf in the fridge, should it be needed later.

Answer: With the topical medications

Since it is a topical cream, it should go with the topical medications (drugs that are to be applied to the outside surface of the body and not in the eye). Nystatin is an antifungal drug that is available as a powder, an oral liquid, a cream, and it comes in other forms as well.

Answer: It is under lock and key with the other controlled substances

The federal government has designated a "control schedule" for certain medications with abuse potential. A rating of C-I means there is no accepted medical use for a drug, and it is (simply put) illegal. A rating of C-II means that the drug has a very high potential for abuse, and should be used with caution. The schedule continues through lessening degrees of abuse potential through C-V. Pharmacies and health care providers are responsible for maintaining complete and accurate records of every controlled substance they handle, from purchase to receipt to prescription to administration, waste, and expiration. Needless to say, controlled drugs should be stored in a secure manner.

Not all controlled substances are narcotics. A couple of examples are Valium (a benzodiazepine) and steroids like testosterone. While Ketamine is sometimes used in veterinary practice, it is also a C-III anesthetic used on humans.

Thank you for playing my first quiz. I hope you found it fun and interesting.