Few More Questions about CPJE:
1) Did they ask about HEPATIC dose adjustments based on Childs Pugh Score?
2) Did they ask to dose adjust based on DDI: especially 3YA4 and 2D6
3) Consider this clozapine question (given on PSI sample test):
A 37 year old patient with schizophrenia hs been treated with clozapien for the past 4 months. The dose is 500mg daily. The patient has the following past CBC results:
WBC Neutrophiles
June 30 10.1 7.3
June 22 10.7 7.4
June 16 6.5 3.5
June 9 6.3 3.4
June 2 6.7 3.8
On July 7, the patients WBC is 7.2 and Neutrophils are 4.3. The MOST APPROPRIATE decision regarding his weekly clozapine prescription for 500mg daily is to:
A. Fill as written
B. discontinue therapy
C. Hold therapy for 1 week and resume 400mg daily
D. Repeat CBC and fill if WBC is greater than 8.
The correct answer is A, but my question is the units presented in this question. Its just numbers. According to Pharmacy Charts, Clozapine monitoring values are:
ANC > 1500/mm3 Gen pop normal range
1000mm3 > ANC > 1499/mm3 Mild Neutropenia
500mm3 > ANC > 999/mm3 Moderate Neutropenia
ANC<500mm3 Severe neutropenia
How would 4.3 be represented in mm3? Will you also be presented a question to calculate ANC? The equation is ANC = WBC x (segs+bands) How would you identify segments and bands?
4) To calculate some dilution method? Can someone give an example of that?
5) To calculate CORRECTED phenytoin level based on serum albumin level. Can someone give an example of that?
6) Adjusted Body Weight vs Actual Body Weight vs Ideal Body weight. Can someone give an example on when to use what when determining CrCl?
7) Did they ask to disgtinguish name brands with different formulations and dosage indication? Example: Glargine (Lantus) vs Glargine (Basaglar) and Finesteride (proscar) vs Finesterine (propecia) and Fentanyl : Fentora, Onsolis, Abstral, Lazanda, Subsys
8) From knowing the different pregnancy categories, do they ask which pregrancy category are certain drugs? Example: Methotrexate is pregnancy category x [d if used in cancer tx]
I am taking it this saturday 5-15, and my last chance to take it, help much appreciated !