1. AB is a 56-year-old male presenting to pick up his prescription from your pharmacy when you notice his words are difficult to understand. You ask if his difficulty speaking is new and he says it started about 2 months ago and is worsening. He also complains of dizziness, tripping due to his right foot “not working,” and tight leg muscles. Of the symptoms that AB is experiencing, which is NOT commonly associated with amyotrophic lateral sclerosis?

2. A pharmacy technician asks you how to communicate with a patient diagnosed with amyotrophic lateral sclerosis who is unable to speak, but has preserved hand function, and presents to the pharmacy alone. You have no release of information authorization form on file. Which of the following is the best response?

3. A patient's caregiver asks about uses for dextromethorphan/quinidine supported by human studies. Which of the following uses for dextromethorphan/quinidine have at least some published trial data?

4. CD drops off her first prescription for riluzole. She asks what this medication is used for and if there are any alternatives. As the pharmacist, what is your best response?

5. EF is a 37-year-old female diagnosed with bulbar-onset amyotrophic lateral sclerosis 9 months ago. Her primary care provider has asked for help prescribing a medication for EF's episodes of uncontrollable crying. She has recently had a gastric feeding tube (FT) placed and takes all of her medications via the FT. Her past medical history includes chronic constipation and major depressive disorder and her current medications include senna 8.6 mg per FT daily and sertraline 200 mg per FT daily. Which of the following is the best choice for EF?

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