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Clinical Pharmacy Flashcards

7 cards from real Pharmacy practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 68-year-old diabetic patient on metformin develops acute kidney injury (eGFR 28 mL/min/1.73m²). What is the recommended action?

    Answer: Discontinue metformin due to lactic acidosis risk

    Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² because accumulation increases lactic acidosis risk.

  2. Which antibiotic class is associated with QT prolongation and should be used cautiously with antiarrhythmics?

    Answer: Fluoroquinolones

    Fluoroquinolones block cardiac hERG potassium channels, prolonging the QT interval and risking torsades de pointes.

  3. A patient on phenytoin requires total parenteral nutrition (TPN). What drug interaction is clinically important?

    Answer: Phenytoin is absorbed by the TPN tubing, reducing serum levels

    Phenytoin adsorbs to PVC tubing and is incompatible with dextrose solutions, significantly reducing bioavailability during enteral or IV administration with TPN.

  4. A 45-year-old woman is prescribed isotretinoin. Which risk management program must be followed?

    Answer: REMS with iPLEDGE

    Isotretinoin is teratogenic and requires enrollment in the iPLEDGE REMS program to prevent fetal exposure.

  5. Which parameter is used to assess aminoglycoside efficacy in concentration-dependent killing?

    Answer: Peak concentration to MIC ratio (Cmax/MIC)

    Aminoglycosides exhibit concentration-dependent killing; efficacy correlates best with the peak-to-MIC ratio (Cmax/MIC ≥10).

  6. A patient receiving heparin develops a drop in platelet count from 280,000 to 90,000 on day 8. What condition should be suspected?

    Answer: Heparin-induced thrombocytopenia (HIT)

    HIT classically occurs 5–10 days after heparin initiation and is caused by antibodies against the heparin-PF4 complex, requiring immediate heparin cessation.

  7. Which hepatic condition requires dose reduction of drugs that are high-extraction-ratio drugs administered orally?

    Answer: Cirrhosis with significantly reduced hepatic blood flow

    High-extraction drugs (e.g., morphine, propranolol) undergo significant first-pass metabolism; cirrhosis reduces hepatic blood flow and enzyme activity, dramatically increasing oral bioavailability.