AANP Pharmacology 1 — Questions and Answers
Question 1: Which drug class is first-line for treating hypertension in patients with diabetes and microalbuminuria?
- ACE inhibitors (Correct answer)
- Beta-blockers
- Calcium channel blockers
- Loop diuretics
Correct answer: ACE inhibitors
ACE inhibitors provide renoprotective effects in diabetic patients with microalbuminuria, making them the preferred antihypertensive class.
Question 2: A patient taking warfarin begins a course of fluconazole. What is the expected interaction?
- Decreased INR due to reduced warfarin absorption
- Increased INR due to CYP2C9 inhibition (Correct answer)
- No clinically significant interaction
- Decreased INR due to CYP induction
Correct answer: Increased INR due to CYP2C9 inhibition
Fluconazole inhibits CYP2C9, the primary enzyme that metabolizes warfarin, leading to elevated warfarin levels and increased INR.
Question 3: Which antibiotic class is contraindicated in children under 8 years due to tooth discoloration and bone growth inhibition?
- Penicillins
- Cephalosporins
- Tetracyclines (Correct answer)
- Macrolides
Correct answer: Tetracyclines
Tetracyclines bind calcium and deposit in developing teeth and bones, causing permanent discoloration and potential growth retardation in children under 8.
Question 4: What is the mechanism of action of metformin in type 2 diabetes?
- Stimulates pancreatic insulin secretion
- Inhibits hepatic glucose production and improves insulin sensitivity (Correct answer)
- Blocks intestinal glucose absorption
- Increases renal glucose excretion
Correct answer: Inhibits hepatic glucose production and improves insulin sensitivity
Metformin primarily works by inhibiting hepatic gluconeogenesis and improving peripheral insulin sensitivity without causing hypoglycemia.
Question 5: A patient on lithium develops nausea, tremor, and polyuria. Which action is most appropriate?
- Increase sodium intake and check lithium level (Correct answer)
- Discontinue lithium immediately without checking levels
- Add a diuretic to manage polyuria
- Reduce caffeine intake only
Correct answer: Increase sodium intake and check lithium level
Lithium toxicity can be precipitated by sodium depletion; increasing sodium intake helps renal lithium excretion, and checking the serum level guides further management.
Question 6: Which medication requires monitoring of thyroid function tests due to risk of hypothyroidism or hyperthyroidism?
- Metoprolol
- Amiodarone (Correct answer)
- Lisinopril
- Atorvastatin
Correct answer: Amiodarone
Amiodarone contains a large amount of iodine and can cause both hypothyroidism and hyperthyroidism, requiring regular thyroid function monitoring.
AANP Pharmacology 1
Which drug class is first-line for treating hypertension in patients with diabetes and microalbuminuria?