Clinical Therapeutics Flashcards
6 cards from real PSI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Clinical Therapeutics flashcards as text
What is the mechanism of action of proton pump inhibitors (PPIs) such as omeprazole?
Answer: They irreversibly inhibit the hydrogen-potassium ATPase enzyme (proton pump) in gastric parietal cells, reducing gastric acid secretion
PPIs work by irreversibly binding to the H+/K+-ATPase enzyme system (the proton pump) on the surface of gastric parietal cells. This blocks the final step of acid production, providing potent and long-lasting suppression of gastric acid secretion.
A patient is prescribed warfarin. Which of the following interactions should the pharmacist be most concerned about?
Answer: Concurrent use of NSAIDs such as ibuprofen, which increases the risk of bleeding
NSAIDs increase bleeding risk with warfarin through multiple mechanisms: they inhibit platelet function, can cause GI erosion, and some (like fluconazole) inhibit CYP2C9, which metabolises warfarin. Pharmacists should counsel patients about avoiding OTC NSAIDs and reporting any signs of bleeding.
What is the first-line treatment for mild-to-moderate community-acquired pneumonia in adults in Ireland?
Answer: Amoxicillin
According to Irish antibiotic prescribing guidelines, amoxicillin is the first-line treatment for community-acquired pneumonia in adults. For penicillin-allergic patients, doxycycline or clarithromycin are alternatives. This follows antimicrobial stewardship principles.
What counselling points should a pharmacist provide to a patient starting a statin (e.g., atorvastatin)?
Answer: Take at the recommended time, report unexplained muscle pain, have liver function monitored, avoid grapefruit juice in large quantities, and understand it is for long-term use
Key counselling points include: take consistently (some statins are best taken at night), report muscle pain/weakness (risk of rhabdomyolysis), baseline and follow-up liver function tests, avoid excessive grapefruit juice (CYP3A4 interaction with some statins), and emphasise long-term adherence.
What is the difference between a generic medicine and a branded medicine?
Answer: A generic contains the same active ingredient, dose, and dosage form as the brand but is marketed under the non-proprietary (generic) name, usually at a lower cost
Generic medicines must contain the same active ingredient in the same dose and dosage form as the reference (branded) product and must demonstrate bioequivalence. They are approved by the HPRA and meet the same quality standards but are typically less expensive as they do not carry development costs.
What is antimicrobial stewardship and why is it important for pharmacists?
Answer: A systematic approach to optimising antibiotic use by ensuring the right drug, dose, and duration to improve outcomes and reduce antimicrobial resistance
Antimicrobial stewardship involves selecting the optimal antibiotic, dose, and duration of therapy to maximise clinical cure while minimising side effects and the development of antimicrobial resistance. Pharmacists play a key role in reviewing prescriptions, advising prescribers, and educating patients.