CAOP - Competency Assessment of Overseas Pharmacist Therapeutic Area Review Questions and Answers

Question 1

A 25-year-old patient with asthma reports using their salbutamol (SABA) inhaler 4-5 times a week for symptom relief.
They have a prescription for a daily inhaled corticosteroid (ICS) but admit to only using it 'when they feel wheezy'.
When conducting a therapeutic review, which finding indicates the most urgent need for intervention according to the Australian Asthma Handbook?

Accepted Answer

The patient is using more than two salbutamol inhalers per year.

Answer

The patient's reliance on their preventer therapy is inconsistent.

Answer

The patient is not using a combination ICS/LABA inhaler.

Answer

The patient has not been provided with a spacer device.

Question 2

A 68-year-old male with type 2 diabetes and hypertension has a medication profile that includes metformin, perindopril, and atorvastatin. His latest pathology results show an estimated Glomerular Filtration Rate (eGFR) of 28 mL/min/1.73m². Based on this new information, which therapeutic review action is most appropriate?

Accepted Answer

Advise the prescriber to cease the metformin due to the risk of lactic acidosis.

Answer

Recommend adding an SGLT2 inhibitor to improve renal outcomes.

Answer

Suggest increasing the dose of perindopril for better renal protection.

Answer

Recommend switching atorvastatin to rosuvastatin.

Question 3

An 82-year-old female patient with a history of osteoporosis, hypertension, and urinary incontinence presents her medication list for a therapeutic review. The list includes alendronate, hydrochlorothiazide, and oxybutynin. She reports increased confusion and a recent fall. Which medication is most likely contributing to these new symptoms?

Accepted Answer

Oxybutynin

Answer

Alendronate

Answer

Hydrochlorothiazide

Answer

A drug-drug interaction between all three medications

Question 4

A 60-year-old man with hypertension and a history of gout is currently managed with losartan. His blood pressure remains elevated, and his GP considers adding a diuretic. During the therapeutic review, which of the following is the most important consideration for the pharmacist to highlight?

Accepted Answer

Losartan has a mild uricosuric effect that may partially counteract diuretic-induced hyperuricemia.

Answer

Combining losartan with any diuretic increases the risk of hyperkalemia.

Answer

Hydrochlorothiazide is contraindicated in patients with a history of gout.

Answer

Chlorthalidone is a safer alternative to hydrochlorothiazide regarding gout risk.

Question 5

During a therapeutic review for a 72-year-old woman treated for osteoporosis with oral alendronate, the pharmacist notes she has also been taking esomeprazole (a PPI) daily for the last two years for reflux. Which of the following potential issues should be the primary focus of the review?

Accepted Answer

An association between concurrent use and an increased risk of fractures.

Answer

Increased risk of C. difficile infection due to long-term PPI use.

Answer

Reduced absorption of alendronate due to the increased gastric pH.

Answer

The potential for esomeprazole to cause hypomagnesemia.

Question 6

A pharmacist is reviewing the medications of a 78-year-old patient with stable chronic heart failure (ejection fraction 35%), type 2 diabetes, and chronic kidney disease (eGFR 50 mL/min/1.73m²). The patient is on metoprolol, ramipril, and metformin. The GP is considering adding a new agent for glycemic control and cardiovascular/renal benefits. Which of the following would be the most appropriate recommendation?

Accepted Answer

Dapagliflozin, as SGLT2 inhibitors are indicated for heart failure and CKD benefits, independent of diabetes.

Answer

Sitagliptin, due to its neutral effect on heart failure and good safety profile in renal impairment.

Answer

Gliclazide, as it provides effective glucose lowering.

Answer

Pioglitazone, as it can improve insulin sensitivity.