Pharmacology and Prescribing Flashcards
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Read the first 7 Pharmacology and Prescribing flashcards as text
Which medication class is most commonly associated with drug-induced hyponatremia (low serum sodium)?
Answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs cause SIADH (syndrome of inappropriate antidiuretic hormone secretion), resulting in dilutional hyponatremia, particularly in elderly patients.
A patient on digoxin presents with nausea, vomiting, and new-onset visual disturbances (yellow-green halos). What is the most likely cause?
Answer: Digoxin toxicity
The classic triad of GI symptoms plus xanthopsia (yellow-green vision) is pathognomonic for digoxin toxicity, often precipitated by hypokalemia.
Which of the following is the most commonly reported adverse effect of statin therapy?
Answer: Myalgia and muscle weakness
Myalgia (muscle aching and weakness) is the most frequent adverse effect of statins, occurring in up to 10% of patients, while severe rhabdomyolysis is rare.
A patient on long-term amiodarone therapy requires which of the following routine monitoring tests?
Answer: Thyroid function, liver function, pulmonary function, and ophthalmologic exam
Amiodarone contains iodine and is toxic to multiple organs; monitoring must include TFTs (hypo/hyperthyroidism), LFTs (hepatotoxicity), CXR/PFTs (pulmonary fibrosis), and annual eye exams (corneal microdeposits).
Which medication is contraindicated in patients with acute gout because it can paradoxically worsen or prolong an acute attack?
Answer: Allopurinol
Allopurinol should not be initiated during an acute gout attack, as rapidly changing serum urate levels can mobilize urate crystals and prolong the flare.
Which anticoagulant class does NOT require routine INR monitoring due to its predictable pharmacokinetics?
Answer: Direct oral anticoagulants (DOACs)
DOACs (e.g., rivaroxaban, apixaban, dabigatran) have fixed dosing with predictable effects and do not require routine coagulation monitoring unlike vitamin K antagonists.
What is the mechanism of action of proton pump inhibitors (PPIs) such as omeprazole?
Answer: Irreversible inhibition of the H+/K+-ATPase enzyme in gastric parietal cells
PPIs are prodrugs that are activated in the acidic canaliculus of parietal cells, where they covalently and irreversibly bind the H+/K+-ATPase (proton pump), blocking acid secretion.