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.
Read the first 7 Clinical Pharmacy flashcards as text
A hospitalized patient on IV ciprofloxacin is transitioned to oral ciprofloxacin for continued treatment. The physician asks if a dose adjustment is needed. What is the best response?
Answer: No adjustment needed; ciprofloxacin has approximately 70–80% oral bioavailability
Ciprofloxacin has approximately 70–80% oral bioavailability, making IV-to-PO conversion straightforward without dose adjustment.
A patient with heart failure is started on carvedilol. Which counseling point is most important regarding initial therapy?
Answer: Start at low doses and titrate slowly to avoid acute decompensation
Beta-blockers in heart failure must be started at low doses and titrated slowly because abrupt initiation can precipitate acute decompensation.
Which drug interaction mechanism explains the combination of simvastatin and amiodarone causing myopathy?
Answer: Amiodarone inhibits CYP3A4, increasing simvastatin exposure and myopathy risk
Amiodarone inhibits CYP3A4, the primary enzyme metabolizing simvastatin, leading to elevated statin levels and increased risk of myopathy or rhabdomyolysis.
A patient presents with opioid overdose. Which agent is first-line reversal therapy and what is its mechanism?
Answer: Naloxone — competitive opioid receptor antagonist
Naloxone competitively displaces opioids from mu, kappa, and delta receptors, rapidly reversing respiratory depression, sedation, and miosis.
Which monitoring parameter is most important during the first month of ACE inhibitor therapy in a hypertensive patient with CKD?
Answer: Blood pressure, serum potassium, and serum creatinine
ACE inhibitors can cause hyperkalemia and an initial rise in serum creatinine due to efferent arteriolar dilation; monitoring BP, K+, and SCr is essential.
A patient's phenytoin free fraction increases when albumin drops from 4.0 to 2.0 g/dL. What clinical consequence is most likely?
Answer: Toxicity despite a 'normal' total phenytoin level on lab report
Phenytoin is highly protein-bound; hypoalbuminemia increases free (active) drug fraction, causing toxicity even when total phenytoin appears within the normal range.
A pharmacist identifies that a patient is taking two drugs that both prolong the QT interval: haloperidol and azithromycin. What is the most appropriate action?
Answer: Contact the prescriber to discuss the additive risk and explore alternatives
Combining QT-prolonging agents carries additive risk of torsades de pointes; pharmacists must alert the prescriber and collaboratively assess alternatives or monitoring needs.