Pharm E2 practice questions

A patient experiences abdominal cramping and seeks relief. The healthcare provider is considering an anti-emetic specifically for abdominal cramping. Which of the following anti-emetics is most suitable for providing relief from abdominal cramping? A) Hyoscyamine (Levsin) B) Ondansetron (Zofran) C) Aprepitant (Emend) D) Dronabinol (Marinol)

A

Your patient with Hepatitis C recently started a new medication. They present today with complaints of rash, nausea and itchy arms and legs. which drug most likely caused this reaction? A. Simeprevir (Olysio) B. Ombitasvir C. Daclatasvir (daklinza) D. Ribavirin (rebetol)

A

A sexually active female presents with itching and a frothy, malodorous, greenish-yellow vaginal discharge. Wet mount microscopy reveals motile organisms. You diagnose her with Trichomoniasis. What is the most appropriate treatment for this patient? A) Azithromycin B) Metronidazole C) Doxycycline D) Ceftriaxone

B could also use tinidazole

A nurse accidentally pricked herself with a needle used on an HIV-positive patient. Postexposure prophylaxis (PEP) is indicated to reduce the risk of HIV transmission. What is the recommended PEP regimen for this nurse? A) Zidovudine (AZT) + Lamivudine (3TC) + Efavirenz (EFV) for 28 days B) Tenofovir (TDF) + Emtricitabine (FTC) + Raltegravir (RAL) for 4 weeks C) Lopinavir/Ritonavir (LPV/r) + Zidovudine (AZT) + Lamivudine (3TC) for 28 days D) Abacavir (ABC) + Lamivudine (3TC) + Dolutegravir (DTG) for 4 weeks

B start this asap TER=treat every risk

Which of the following would be an appropriate antiretroviral treatment regimen for HIV? A. Stavdine + Lamivudine + Didanosine B. Dolutegravir + Tenofovir + emtricitabine C. Emtricitabine + Nelfinavir + Tipranavir D. Elvitegravir + Raltegravir + Abacavir

B --> 2 NRTI backbone plus another antiretroviral (in this case an integrase inhibitor)

A 35-year-old male is diagnosed with hyperprolactinemia secondary to a pituitary adenoma. The healthcare provider decides to initiate treatment with cabergoline. As part of the counseling session, which side effect should the patient be specifically warned about? A) Weight gain B) Orthostatic hypotension C) Insomnia D) Photosensitivity

B --> monitor BP

You recently diagnosed a patient with syphilis. They have a severe penicillin allergy. What should you treat with? A. Pen G under allergist supervision B. Doxycycline C. Tetracycline D. Azithromycin

B and C are alt to pen G

A patient with HIV, presenting with a low CD4 count, is at risk for Pneumocystis jirovecii pneumonia (PJP). Which antibiotic is considered the best choice for prophylaxis against PJP in this patient? A) Azithromycin B) Clindamycin C) Trimethoprim-sulfamethoxazole (bactrim) D) Ciprofloxacin

C prophylaxis is indicated when CD4 <200 or hx of thrush

You diagnosed a patient with gonorrhea. You also suspect co-infection with chlamydia. How should you treat? A. 1 Ceftriaxone (rocephin) IM dose only B. Azithromycin and gentamicin C. Ceftriaxone (rocephin) and doxycycline D. Doxycycline only

C rocephin for gonorrhea and doxy for chlamydia

A 35-year-old female is diagnosed with hypothyroidism and prescribed synthroid. What point of education should be emphasized to the patient regarding medication administration? A) Take the medication on an full stomach in the morning. B) Ensure adequate intake of iron and calcium while on the medication. C) Do not take iron, calcium, or aluminum-containing supplements with the drug. D) Administer the medication with a high-fat meal for optimal absorption.

C they interfere with absorption

A 34 year old female with PMHx of HIV just found out she is pregnant. Which of the following should be given to prevent transmission to the fetus and which drug should be avoided due to risk of neural tube defects? A. Etravirine; Efavirenz B. Delaviridine; Tenofovir C. Zidovudine; Efavirenz D. Zidovudine; Tenofovir

C --> should also be given to the fetus for 4-6 weeks after birth

Which adverse effect is more common in TCAs due to muscarinic receptor blockade? a) Weight gain b) Hypertension c) Dry mouth d) Sexual dysfunction

C -->anticholinergic effects

A 64 year old male was recently diagnosed with prostate cancer. He has hx of hypogonadism, HTN, arthitis and HLD. Med list includes Androgel, Somatostatin, amlodipine and ibu profen. Which of this drugs should be immediately discontinued? A. Ibu profen B. Somatostatin C. Androgel D. amlodipine

C. testosterone would just feed the cancer!!

A 55-year-old patient with depression is started on trazodone (Desyrel) for insomnia. The patient develops dizziness and orthostatic hypotension. Which receptor blockade is most likely contributing to these side effects? a) Serotonin b) Norepinephrine c) Dopamine d) Alpha-1 adrenergic

D

Your patient with HBV presents with concerns of increased suicidal ideation and depression. They have hx of depression managed with zoloft. Which drug is most likely worsening their depression? A. Tenofovir B. Daclatasvir C. Ribavirin D. Interferon-A

D B and C are HCV treatments :P but ribavirin DOES cause depression/SI!

A patient undergoing treatment for bipolar disorder experiences hyponatremia and SIADH. Which mood-stabilizing drug is more likely to be associated with SIADH? a) Lithium b) Carbamazepine c) Valproic acid d) Oxcarbazepine

D B and D both cause it, but D causes it more!

What is the primary mechanism of action of antithyroid drugs, such as methimazole and propylthiouracil? A) Stimulation of thyroid hormone synthesis B) Inhibition of thyroid hormone release C) Inhibition of thyroid hormone synthesis D) Blockade of thyroid hormone receptors

C

Which drugs are considered first line for HBV and have low resistance? A. Lamivudine and Adefovir B. Entecavir and Adefovir C. Tenofovir and Entecavir D. Telbivudine and Tenofovir

C

Which of the following medications is a CYP3A4 and P-glycoprotein inducer? a) Venlafaxine b) Trazodone c) St. John's Wort d) Mirtazapine

C

A patient with irritable bowel syndrome (IBS) is prescribed a medication that acts as a 5-HT3 receptor antagonist. Which of the following drugs is most likely to be prescribed? A) Ondansetron (Zofran) B) Prochlorperazine (Compazine) C) Loperamide (Imodium) D) Lubiprostone (Amitzia)

A

Which SNRI has a potential dose-related increase in systolic blood pressure? a) Venlafaxine (Effexor) b) Desvenlafaxine (Pristiq) c) Duloxetine (Cymbalta) d) Levomilnacipran (Fetzima)

A

A 45-year-old patient presents to the emergency room with complaints of rapidly progressing facial and tongue swelling, difficulty breathing, and widespread blistering of the skin. The patient reports taking multiple medications for diabetes management. Which of the following drugs is most likely responsible for these reactions? A) Metformin (Glucophage) B) Linagliptin (Tradjenta) C) Pioglitazone (Actos) D) Insulin glargine (Lantus)

B DPP-4 inhibitors can cause angioedema, anaphylaxis and rash (SJS)

A patient with bipolar disorder is prescribed lithium. What critical risk of lithium therapy requires regular monitoring to prevent adverse effects? a) Liver function tests (LFTs) b) Renal function c) Serum electrolytes d) Blood glucose levels

B (risk of nephrotoxicity)

A 60-year-old patient with PMHx of congestive heart failure (CHF) was recently diagnosed with Type 2 Diabetes Mellitus and is being considered for antidiabetic therapy. Which medication should NOT be initiated in this patient due to its potential adverse effects on fluid retention and exacerbation of heart failure? A) Metformin (Glucophage) B) Glyburide (Diabeta) C) Pioglitazone (Actos) D) Sitagliptin (Januvia)

C TZDs cause expanded blood volume, edema, and can worsen HF also monitor liver!!

A 65-year-old patient with Type 2 Diabetes Mellitus is scheduled for elective surgery. The patient is currently on a combination therapy regimen for diabetes management. Which of the following medications should be stopped before surgery due to the risk of lactic acidosis? A) Glipizide (Glucotrol) B) Canagliflozin (Invokana) C) Metformin (Glucophage) D) Insulin glargine (Lantus)

C also risk of fatal lactic acidosis in renal impaired patients!!

A patient with bipolar disorder experiences persistent hand tremors despite adjustments in medication formulation. Which specific formulation or strategy may be considered to alleviate the hand tremors associated with lithium therapy? a) Switch to a different mood stabilizer b) Combine lithium with an antipsychotic c) Utilize a long-acting formulation of lithium d) Administer an anticholinergic medication

C or beta blockers!

A 28-year-old female with a recent diagnosis of Crohn's disease presents with mild to moderate symptoms. The physician decides to initiate pharmacological therapy to induce and maintain remission. Which of the following treatment options is a first-line choice for managing mild to moderate Crohn's disease? a) Infliximab (Remicade) b) Azathioprine (Imuran) c) Mesalamine (Pentasa) d) Methotrexate

C (could also use sulfasalazine but pentasa has less SE)

which of the following UC meds are most likely to cause an anaphylactic reaction? A. Methotexate B. Cyclosporine C. Infliximab (remicade) D. Budesonide

C (monoclonal abs have risk of anaphylaxis)

A 22-year-old patient has recently been diagnosed with type 1 diabetes mellitus and is being initiated on insulin therapy. The patient expresses a preference for using a continuous subcutaneous infusion. Which of the following insulins would be the most suitable choice for this patient? A) Humalog (insulin lispro) B) Lantus (insulin glargine) C) Novolin N (insulin isophane) D) Levemir (insulin detemir)

A and C are regular, short acting insulin best for infusions; they are good for quick corrections and meals

A 45-year-old patient with a history of depression presents with complaints of erectile dysfunction while on fluoxetine (Prozac). Which medication with less sexual dysfunction side effects may be more preferable for this patient? a) Sertraline (Zoloft) b) Bupropion (Wellbutrin) c) Venlafaxine (Effexor) d) Duloxetine (Cymbalta)

B

A 55-year-old patient with a history of liver disease is prescribed an antidepressant. Which mixed serotonergic agent is not commonly used due to cases of liver failure? a) Trazodone (Desyrel) b) Nefazodone (Serzone) c) Mirtazapine (Remeron) d) Vilazodone (Viibryd)

B

A patient undergoing Cisplatin chemotherapy for cancer is prescribed an anti-emetic to prevent nausea and vomiting. Which of the following is used for vomiting due to chemo in both the acute and delayed phase? A) Ondansetron (zofran) B) Arepitant (Emend) C) Prochlorperazine (Compazine) D) Glycopyrrolate (Robinul)

B

A patient with a PMHx of seizures and arrhythmias is seeking an antidepressant. Which medication should be avoided due to its potential to trigger seizures? a) Duloxetine (Cymbalta) b) Bupropion (Wellbutrin) c) Mirtazapine (Remeron) d) Sertraline (Zoloft)

B

A patient with a history of kidney stones should avoid which antacid due to its potential to increase kidney pH? A) Sodium Bicarbonate B) Calcium Carbonate (Tums) C) Aluminum Hydroxide D) Magnesium Hydroxide

B

A patient with bipolar disorder experiences increased thirst and urination while on lithium therapy. What condition is commonly associated with lithium and can be managed with diuretics? a) Hyperthyroidism b) Nephrogenic diabetes insipidus c) Hypoglycemia d) Metabolic alkalosis

B

A patient with diarrhea-predominant irritable bowel syndrome (IBS) is prescribed a medication that acts as a 5-HT3 receptor antagonist to reduce gastrointestinal motility. Which of the following medications is most likely prescribed? A) Loperamide (Imodium) B) Alosetron (Lotronex) C) Dicyclomine (Bentyl) D) Psyllium (Metamucil)

B

A patient with undiagnosed bipolar disorder is prescribed an SSRI. What potential risk should be considered when initiating this treatment? a) Increased risk of seizures b) Manic episode induction c) Hypertensive crisis d) Serotonin syndrome

B

In what way do TCAs and SSRIs primarily differ? a) Efficacy b) Adverse effects c) Onset of action d) Half-life duration

B

What is the immunosuppressant that is commonly used for the treatment of IBD and carries a risk of nephrotoxicity, HTN, infection, and hirsutism? a) Infliximab (Remicade) b) Cyclosporine (Neoral) c) Methotrexate d) Adalimumab (Humira)

B

When should alpha-glucosidase inhibitors, such as Miglitol (Glyset), be taken in relation to meals? A) 30 minutes before a meal B) With the first bite of a meal C) 1 hour after a meal D) Anytime during the day

B

Which SSRIs have the potential to cause QT prolongation? a) Fluoxetine and Sertraline b) Citalopram and Escitalopram c) Paroxetine and Fluoxetine d) Sertraline and Paroxetine

B

Which antacid can cause increased kidney pH and kidney stones? a) Sodium bicarbonate b) Calcium carbonate (Tums) c) Aluminum hydroxide (Amphagel) d) Magnesium hydroxide (Milk of Magnesia)

B

Which of the following is the preferred drug regimen for treatment of H. Pylori-induced ulcers? A. Clarithromycin + amoxicillin + omeprazole B. Metronidazole + tetracycline + omeprazole + bismuth C. Metronidazole + amoxicillin + Lansoprazole D. Keflex + amoxicillin + bismuth + famotidine

B 4 drug regimen is preferred. --> bismuth + 2 abx + PPI

A 28-year-old patient with type 1 diabetes mellitus experiences symptoms of hypoglycemia, including shakiness and confusion. Which of the following would be the most appropriate intervention for this patient? A) Administering 1 mg of glucagon intramuscularly B) Providing 4 glucose tablets C) Starting a continuous intravenous infusion of dextrose D) Initiating treatment with metformin

B A and C are technically correct but would be used for unconscious/crashing pts. this pt is conscious and can eat!

What is the primary reason for the long-lasting effects of MAOIs? a) Reversible inhibition of MAO-A and MAO-B b) Irreversible inhibition of MAO-A and MAO-B c) Selective inhibition of MAO-B d) Lack of interaction with other neurotransmitters

B IRREVERSIBLY inhibits MAO-A and MAO-B → affects the metabolism of serotonin, NE, and DA → leads to food/drug interactions

which of the following drugs has the MOA of decreasing hepatic glucose production, increasing the peripheral uptake and utilization of glucose and decreasing glucose absorption from the GI tract? A. Rosiglitazone (Avandia) B. Metformin (glucophage) C. Nateglinide (Starlix) D. Acetohexamide (Dymelor)

B i dont think he'll ask a question like this, but metformin is the 1st line med so it is good to know the MOA :)

A patient on antipsychotic medications develops hyperthermia, autonomic dysregulation, altered mental status, and generalized muscle rigidity. Which drug is most appropriate for the treatment of neuroleptic malignant syndrome (NMS)? A) Haloperidol B) Bromocriptine C) Olanzapine D) Lorazepam

B can also use dantrolene

A 7-year-old child presents to the ER with confusion, vomiting, diarrhea, and hepatomegaly. The mother reports giving the child a drug to help with the child's nausea they have been experiencing when they were sick with the flu. Which drug is most likely to have caused the child's symptoms? A. Acetaminophen (tylenol) B. Colloidal bismuth (Pepto-Bismol) C. Misoprostol (Cyotec) D. Sucralfate (Carafate)

B (Reye's syndrome --> pepto bismol has salicylates)

A patient with a history of opioid avoidance due to potential misuse is prescribed an antidepressant for sleep. Which mixed serotonergic agent is commonly used for sleep in such cases? a) Fluoxetine (Prozac) b) Nefazodone (Serzone) c) Trazodone (Desyrel) d) Mirtazapine (Remeron)

B and C (mixed serotonergic agent)

A 22-year-old patient is brought to the emergency department after ingesting a large quantity of pills in a suicide attempt. The healthcare provider identifies the ingestion of a tricyclic antidepressant (TCA) based on the patient's medication history. Which of the following physiological effects is most commonly associated with TCAs and requires immediate attention? A) Bradycardia B) Hypotension C) Hyperthermia D) Prolonged QT interval

B →TCAs cause hypotension bc of alpha receptor blockade they prolong the QRS not the QT!!

A 28 year old pregnant patient presents with complaints of gastric reflux. Which drug should be avoided in this patient due to the risk of edema? A) Pepto-Bismol B) Misoprostol C) Sodium Bicarbonate D) Ondansetron (Zofran)

C

A 30-year-old female with fibromyalgia complains of persistent nausea and dry mouth while on medication. Which serotonin-norepinephrine reuptake inhibitor (SNRI) is most likely responsible for these adverse effects? a) Venlafaxine (Effexor) b) Desvenlafaxine (Pristiq) c) Duloxetine (Cymbalta) d) Milnacipran (Savella)

C

A 30-year-old patient, newly diagnosed with bipolar disorder, experiences fine hand tremors and polydipsia. Which mood stabilizer is most likely responsible for these acute adverse effects? a) Valproic acid (Depakote) b) Carbamazepine c) Lithium d) Olanzapine (Zyprexa)

C

A 45-year-old obese patient with type 2 diabetes mellitus is currently on medication, but despite treatment, there has been no improvement in weight. Which of the following medications is most suitable for this patient, considering its potential benefit of weight loss? A) Alogliptin (Nesina) B) Glimepiride (Amaryl) C) Dapagliflozin (Farxiga) D) Glipizide (Glucotrol)

C

A healthcare provider is initiating a patient on an antipsychotic medication for schizophrenia. What black box warning is associated with the use of certain second-generation antipsychotics and should be monitored regularly during treatment? a) Extrapyramidal symptoms (EPS); Motor rigidity and tremor b) Tardive dyskinesia; Involuntary movements c) Increased mortality in elderly patients with dementia-related psychosis d) Neuroleptic malignant syndrome (NMS); Hyperthermia and altered mental status

C

A patient on valproic acid (depakote) is prescribed carbamazepine. How does valproic acid affect the metabolism of carbamazepine? a) Inhibits CYP3A4 b) Enhances renal excretion c) Displaces carbamazepine from serum proteins d) Increases plasma concentrations

C

A patient presents with chronic drooling, and the healthcare provider is considering an anti-emetic for symptomatic relief. The patient desires a non-sedating option. Which of the following anti-emetics is most suitable for chronic drooling without sedative effects? A) Scopolamine B) Ondansetron (Zofran) C) Glycopyrrolate D) Metoclopramide (Reglan)

C

A patient with bipolar disorder is prescribed lithium. What electrolyte does lithium most closely resemble in the body? a) Potassium b) Calcium c) Sodium d) Magnesium

C

A patient with bipolar disorder recently started a new medication. The patient develops a rapidly spreading rash, blistering, and mucosal involvement, along with fever and malaise. Which medication is most likely responsible for these symptoms? a) Lithium b) Venlafaxine c) Lamotrigine d) Mirtazapine

C

A patient with gastroesophageal reflux disease (GERD) is prescribed a medication that directly neutralizes stomach acid. Which of the following drugs belongs to this category? A) Omeprazole (Prilosec) B) Famotidine (Pepcid) C) Sodium Bicarbonate D) Sucralfate (Carafate)

C

How long does it typically take for anti-depressants to take full effect? a) 2-6 hours b) 2-6 days c) 2-6 weeks d) 2-6 months

C

Which adverse effect is particularly associated with Mirtazapine (Remeron) due to its histamine receptor antagonism? a) Sexual dysfunction b) Weight loss c) Somnolence d) Nausea

C

Which antacid has drug interactions due to chelation? a) Sodium bicarb b) Calcium carbonate (Tums) c) Aluminum hydroxide (Amphagel) d) Magnesium hydroxide (Milk of magnesia)

C

Which anti-diarrheal is used for infectious diarrhea and imparts a black color to the oral cavity and feces? a) Loperamide (Imodium) b) Diphenoxylate (Lomotil) c) Pepto-Bismol d) Docusate sodium (Colace)

C

Which anti-emetic drug has only antimuscarinic actions and is beneficial for preventing motion sickness without sedation? a) Metoclopramide b) Ondansetron (Zofran) c) Scopolamine d) Diphenoxylate (Lomotil)

C

Which class of antidepressants may be used for fibromyalgia and peripheral neuropathies? a) TCAs b) SSRIs c) SNRIs d) MAOIs

C

A 68-year-old patient with Type 2 Diabetes Mellitus has a creatinine clearance of 40 mL/min and is in need of glucose-lowering medication. Considering the renal impairment, which antidiabetic agent would be most appropriate for this patient? A) Metformin (Glucophage) B) Glyburide (Diabeta) C) Sitagliptin (Januvia) D) Dapagliflozin (Farxiga)

C A: metformin cannot be used in renally impaired B: glyburide (sulfonylurea) are excreted in urine so you use cautiously in renal/hepatic impaired D: SGLT2 inhibitors are renally excreted

73 year old female presents with complaints of insomnia. She reports that she cannot fall asleep and often wakes up in the middle of the night. Which of the following would be most appropriate to treat her with? A. Diazepam B. Clonazepam C. Triazolam D. Atomoxetine (Strattera)

C Part of the LOTT drugs → hydrophilic, with less (if any) active metabolites → cleared better in elderly/organ failure pts

In serotonin syndrome, what is the role of cyproheptadine in the treatment? a) NMDA receptor antagonism b) Evaporative cooling c) Serotonin blockade d) MAO inhibition

C other treatment includes: - IV fluids - evaporative cooling

What is the primary risk associated with abrupt discontinuation of SSRIs? a) Hypertensive crisis b) Suicidal ideation c) Discontinuation/withdrawal phenomenon d) QT prolongation

C sx = anxiety, sleep disturbances, increased sx recurrence risk (occurs less with longer-half lives or active metabolites like prozac)

A 65-year-old patient with a history of depression presents with severe nausea and vomiting. The patient has been taking an anti-emetic for the past week. On examination, the ECG reveals QT prolongation. Which of the following antiemetics is most likely responsible for the observed QT prolongation in this patient? A) Promethazine (Phenergan) B) Dimenhydramine (Dramamine) C) Granisetron (Kytril) D) Nabilone (Cesamet)

C (anti-serotonergic anti-emetics: zofran, dolasetron and granisetron (-setron) can cause QT prolongation)

A 45-year-old female with type 2 diabetes mellitus is currently taking metformin but is not achieving glycemic control. Her physician decides to add a medication that stimulates insulin secretion. Which of the following drugs is most likely to be prescribed? a) Pioglitazone b) Sitagliptin c) Glipizide d) Canagliflozin (Invokana)

C glipizide is a sulfonylurea which increases insulin release (Meglitinides also increase insulin secretion)

A patient with T1DM is considering a basal insulin regimen with injections in the morning and evening. Which insulin analog would be most suitable for this schedule? A) Lispro B) Afrezza C) Glargine D) NPH

C long acting/ultra long acting are best for basal

When you start a patient on testosterone, what lab should be monitored every few months? why? A. CMP; liver function B. TSH; thyroid function C. CBC; blood count D. CBC; infection

C test can cause erythrocytosis

a patient accidentally took a double dose of their Dimenhydrinate (Dramamine). Which of the side effects would be most likely to be present? A. Diarrhea B. Excessive sweating C. Sedation D. Skin pallor

C (increased antimuscarininc side effects)

Why are aluminum hydroxide and magnesium hydroxide commonly used together? A) To enhance gastric emptying B) To prevent kidney stone formation C) To balance constipating and diarrhea-inducing effects D) To increase mucosal protection

C (AKA Mylanta)

A 34 year old female with Ulcerative colitis has been taking a new drug for 3 months. Recently, she presented with complaints of increased hair growth, especially on her chin and chest. Which drug most likely caused this and which other side effect should you monitor for? A. Methotrexate (Trexall); hepatotoxicity B. Cyclosporine (Neoral); hepatotoxicity C. Methotrexate (Trexall); nephrotoxicity D. Cyclosporine (Neoral); nephrotoxicity

D

A former drug addict with a history of substance abuse is seeking treatment for anxiety but cannot take benzodiazepines due to concerns about potential misuse. Which non-benzodiazepine anxiolytic would be most appropriate for this individual? a) Lorazepam b) Clonazepam c) Diazepam d) Buspirone

D

A patient with a history of peptic ulcer disease experiences black stools and notices a black coloration in the oral cavity. The patient recalls taking a medication for ulcer relief. Which of the following medications is most likely to have caused the patient's symptoms? A) Sucralfate (Carafate) B) Misoprostol (Cytotec) C) Omeprazole (Prilosec) D) Pepto-Bismol

D

In a patient with hyperkalemia, how does insulin primarily contribute to the reduction of serum potassium levels? A) Inhibits potassium reabsorption in the renal tubules B) Increases potassium excretion in the urine C) Enhances the release of potassium from cells into the bloodstream D) Pushes potassium into the cells from the extracellular fluid

D

What is the first-line therapy for Major Depressive Disorder (MDD)? a) MAOIs b) SNRIs c) TCAs d) SSRIs

D

Which class of drugs may cause hypertensive crisis when consuming tyramine-containing foods? a) SSRIs b) TCAs c) SNRIs d) MAOIs

D

Which medications have the mechanism of action of preventing the breakdown of catecholamines (serotonin and NE)? a) TCAs b) SSRIs c) SNRIs d) MAOIs

D

A 58-year-old patient with Type 2 Diabetes Mellitus presents with complaints of fatigue, weakness, and tingling sensations in the extremities. Lab results reveal a deficiency in vitamin B12 and low H/H. Which medication is most likely responsible for this deficiency? A) Repaglinide (Prandin) B) Glipizide (Glucotrol) C) Pioglitazone (Actos) D) Metformin/Glipizide (Metaglip)

D Biguanides can cause megaloblastic anemia d/t decreased b12 absorption

A same-sex male couple is seeking guidance on HIV prevention, and one partner is known to be HIV-positive. What is the recommended pre-exposure prophylaxis (PrEP) treatment for the HIV-negative partner? A) Tenofovir (TDF) + Emtricitabine (FTC) B) Lamivudine (3TC) + Abacavir (ABC) C) Raltegravir (RAL) + Darunavir (DRV) D) Efavirenz (EFV) + Lopinavir/Ritonavir (LPV/r)

A (AKA Truvada) should be given daily

A 35-year-old patient with a history of HIV infection presents to the emergency department with severe abdominal pain, nausea, and vomiting. Laboratory tests reveal elevated pancreatic enzymes. The patient is on a combination antiretroviral therapy (ART) regimen that includes Didanosine/Emtricitabine (DDI/FTC) + Atazanavir (ATV) + Ritonavir (RTV). Which drug in the regimen is most likely responsible for the symptoms of pancreatitis? A) Didanosine/Emtricitabine (DDI/FTC) B) Atazanavir (Reyataz) C) Ritonavir (Norvir) D) All of the above

A --> NtRTIs have risk of pancreatitis! especially didanosine, stavudine, and ziovudine (they have the worst side effects)

A 45-year-old female presents to the clinic with a three-month history of fatigue, weight loss, and hyperpigmentation of the skin. Laboratory tests show hyponatremia, hyperkalemia, and low plasma cortisol levels. Based on these findings, what would be the most appropriate treatment regimen for this patient? A) Hydrocortisone and fludrocortisone daily B) Prednisone alone C) Hydrocortisone alone D) Methylprednisolone and aldosterone replacement

A --> addison disease

Which of the following ART drugs will prevent viral DNA from being incorporated into chromosomal DNA? A. Dolutegravir (Tivicay) B. Maraviroc (Selentry) C. Enfuviritide (Fuzeon) D. Indinavir (Crixivan)

A --> integrase inhibitor MOA

A patient with hyperthyroidism secondary to a multinodular goiter presents to the ER with rash, fever, aphthous ulcers and swollen salivary glands. They can't remember which drug they are on for their hyperthyroidism. Which drug most likely caused this reaction? A. iodide B. methimazole C. prophylthiouracil D. synthroid

A --> iodism

A 28-year-old female presents to the gynecologist with concerns about infertility. She reports difficulty conceiving for 8 months and mentions irregular menstrual cycles. Further investigation reveals elevated levels of prolactin in her blood. The patient expresses her desire to conceive and is seeking appropriate treatment. Which drug would be the most appropriate to treat her with? A) Bromocriptine B) Leuprolide C) Cabergoline D) Spironolactone

A --> used for ovulation induction and treats hyperprolactinemia cabergoline also treats hyperprolactinemia but doesn't initiate ovulation

Which of the following drugs can be given in addition to ART regimen to lead to higher drug levels due to CYP3A4 inhibition? A. Ritonavir B. Lopinavir C. Cobicistat D. Fosamprenavir

A and C --> strong cyp3a4 inhibitors = less frequent dosing!

which of the following drugs for treatment of HIV prevents DNA elongation and is known as a chain terminator? A. Ziovudine (Retrovir) B. Rilpivirine (edurant) C. Fosamprenavir (Lexiva) D. Raltegravir (Isentress)

A. --> NtRTI B = NNRTI C= PI D=integrase inhibitor

which of the following would be best to initiate in an obese patient? A. Glipizide (Glucotrol) B. Rosiglitazone (Avandia) C. Repaglinide (Prandin) D. Metformin (glucophage)

D the others (sulfonylurea, TZD, and meglitinides) cause weight gain

A 63 year old male with PMHx of CHF and DVT presents for a follow up. He has FHx of prostate cancer. You are performing a medication review and see that he was recently started on testosterone cypionate. Why would you be concerned about this considering his history? A. Testosterone can cause infertility B. He should not be on testosterone because he will get prostate cancer C. There is no reason for concern D. He may retain sodium and water on testosterone

D --> concerning in CHF pts! A is technically correct but we aren't concerned about fertility in this patient.

A patient with chronic hepatitis C recently initiated treatment with a direct-acting antiviral medication 8 days ago. They now complain of fatigue, weakness, and jaundice. Laboratory results reveal anemia, elevated bilirubin, and reticulocytosis. Which drug is most likely responsible for these symptoms? A) Sofosbuvir B) Ledipasvir C) Daclatasvir D) Ribavirin

D --> hemolytic anemia risk

You recently started your patient with HBV on Adefovir (Hepsera) after they failed Lamivudine (Epivir) due to resistance. What lab should you be monitoring and why? A. CBC; blood dyscrasia B. TSH; thyroid toxicity C. LFTs; hepatotoxicity D. BMP; Nephrotoxicity

D --> monitor creatinine

A 40-year-old patient with PMHx of Grave's disease presents to the emergency room with severe hyperthermia, tachycardia, nausea, vomiting, and confusion. What medication should be considered as an adjunct therapy for rapid reduction of thyroid hormone synthesis in this acute situation? A) Methimazole B) Propylthiouracil (PTU) C) Levothyroxine (Synthroid) D) Iodine contrast (Iopodate)

D --> rapidly inhibits conversion of T4 to T3

50-year-old patient with bipolar disorder is prescribed a mood stabilizer. The patient develops symptoms of hypothyroidism, including fatigue and weight gain. Which mood stabilizer is known for its potential to cause hypothyroidism? A) Lithium B) Carbamazepine C) Valproic Acid D) Lamotrigine

A

A 23 year old male patient presents to the ER with complaints of a painful persistent erection. He is diagnosed with priapism. Which drug most likely caused this? a) Trazodone b) Mirtazapine (Remeron) c) Vortioxetine (Trintellix) d) St. John's Wort

A

A 25-year-old patient with bipolar disorder experiences a manic episode refractory to lithium therapy. Which anticonvulsant may be a useful alternative in this case? a) Carbamazepine b) Valproic acid (Depakote) c) Oxcarbazepine d) Lamotrigine (Lamictal)

A

A 35-year-old patient is diagnosed with attention-deficit/hyperactivity disorder (ADHD) and is prescribed a stimulant medication. The patient experiences increased heart rate, elevated blood pressure, and reduced appetite. Which of the following stimulant medications is most likely responsible for these cardiovascular and appetite-related side effects? A) Methylphenidate B) Atomoxetine C) Modafinil D) Guanfacine

A

A 60-year-old patient on MAOIs presents with symptoms of hypertensive crisis after consuming aged cheese. Which dietary component is a significant contributor to this interaction? a) Tyramine b) Phenylalanine c) Glutamate d) Histamine

A

A patient on lithium presents with symptoms of dehydration and vomiting. What risk does this pose concerning lithium therapy? a) Increased lithium accumulation b) Decreased lithium toxicity c) Improved mood stabilization d) Reduced side effects

A

A patient with a history of gastric ulcers is prescribed an anti-emetic to manage chemotherapy-induced nausea. Shortly after starting the medication, the patient complains of headache and constipation. Which anti-emetic is most likely responsible for the observed side effects of headache and constipation in this patient? A) Dolasetron (Anzemet) B) Scopolamine C) Metoclopramide (Reglan) D) Hydroxyzine (vistaril)

A

A patient with bipolar disorder is being considered for treatment with clozapine. Before initiating therapy, what potential life-threatening adverse effect should be discussed with the patient, and what warrants regular monitoring during treatment? a) Agranulocytosis; Weekly complete blood counts (CBCs) b) QT prolongation; Electrocardiograms (ECGs) c) Hyperlipidemia; Fasting lipid panels d) Neuroleptic malignant syndrome (NMS); Temperature monitoring

A

If a patient is a poor CYP2D6 metabolizer, which antidepressant may have altered metabolism in their system? a) Vortioxetine b) Duloxetine c) Mirtazapine d) Paroxetine

A Vortioxetine (Trintellix) acts as a 5HT agonist, partial agonist and antagonist at various receptors

A patient diagnosed with schizophrenia develops hyperprolactinemia, leading to gynecomastia and menstrual irregularities. Which class of antipsychotic medications is most likely responsible for this endocrine side effect? a) First-generation antipsychotics (FGAs) b) Second-generation antipsychotics (SGAs) c) Benzodiazepines d) Anticonvulsants

A caused by increased prolactin d/t blockage of DA

A 55-year-old male with a history of Type 2 Diabetes Mellitus (T2DM) is brought to the emergency room after experiencing severe nausea, vomiting, and facial flushing shortly after consuming a meal that included a glass of wine. The patient reports taking multiple medications for diabetes, including one recently added by his healthcare provider. On examination, his blood pressure is elevated, and he appears distressed. Which of the following medications is most likely responsible for the symptoms described? A.Chlorpropamide (Diabinese) B. Metformin (Glucophage) C. Glipizide (Glucotrol) D. Pioglitazone (Actos)

A this is the only drug that causes a disulfiram-like rxn it is a first gen sulfonylurea and should be avoided in the elderly

A 38-year-old patient presents with complaints of dizziness, palpitations, and syncope. The electrocardiogram (ECG) reveals a prolonged QT interval. They have PMHx of anxiety, depression, DM, and schizophrenia. Med list includes Quetiapine (seroquel), Jardiance, Fluvoxetine (luvox), and Lorazepam (ativan) Which of the patient's drugs most likely associated with the development of a prolonged QT interval and may increase the risk of torsades de pointes? A) Quetiapine (seroquel) B) Jardiance C) Fluvoxetine (Luvox) D) Lorazepam (ativan)

A SGAs can cause prolonged QT

What is the primary pharmacologic option for treating NSAID-induced ulcers? a) Proton Pump Inhibitors (PPI) b) H2-receptor antagonists c) Misoprostol d) Sucralfate (Carafate)

A (take 30 mins before meal)

Which drug is used for chemical abortion and is contraindicated in pregnancy? a) Misoprostol b) Pepto-Bismol c) Sucralfate (Carafate) d) Ondansetron (Zofran)

A (used for tx of NSAID-induced ulcers!!)

Patient newly diagnosed with HIV admits to being a poorly compliant drug-taker. which HIV drug would be more appropriate for someone who does not take multiple pills well? A. Bictegravir (Biktarvy) B. Maraviroc (Selzentry) C. Enfuviride (Fuzeon) D. Raltegravir (Isentress)

A *** co-formulated with emtricitabine and tenofovir so it is the 2 NRTI + an integrase inhibitor! cabotegravir is a long-acting IM integrase inhibitor that would also be good for compliance

A patient with bipolar disorder is prescribed an antipsychotic medication known for its risk of weight gain and metabolic effects. Which antipsychotic should be closely monitored for glucose intolerance and hyperlipidemia? a) Clozapine b) Risperidone c) Olanzapine (Zyprexa) d) Aripiprazole

A and C clozapine and olanzapine have the highest occurrence of weight gain/metabolic SE, seizures, anti-cholinergic SE

which oral corticosteroid has the least systemic effects and thus would be more tolerable for immunocompromised pts? A. prednisone B. Budesonide C. Methylprednisolon D. Dexamethasone

B-->extensive first pass effect

How long after discontinuing MAOIs may patients continue to experience side effects? A. 5-7 days B. 1 week C. 2 weeks D. 1 month

C

A 58-year-old patient with Type 2 Diabetes Mellitus presents to the emergency room with pruritis, fatigue, pallor, and bruising. Further investigation reveals aplastic anemia. The patient has been on a drug for diabetes management. Which of the following drugs is most likely responsible for the development of aplastic anemia in this patient? A) Metformin (Glucophage) B) Pioglitazone (Actos) C) Repaglinide (Prandin) D) Glyburide (Diabeta)

D sulfonylureas have a risk of aplastic anemia!! other side effects: hypoglycemia, weight gain, constipation, n/d, rash, pruritis, leucopenia, ttp, aplastic anemia, resistance may develop

A 32-year-old patient with UC presents with symptoms suggestive of proctitis, experiencing rectal pain, urgency, and bloody stools. Considering the localized nature of the inflammation, which 5-aminosalicylate (5-ASA) medication would be the most appropriate for this patient? A. Asacol B. Pentasa C. Rowasa D. Canasa

D (rectal suppository)

A 32-year-old patient with extensive UC presents with abdominal pain, diarrhea, and weight loss. The physician considers prescribing a 5-aminosalicylic acid (5-ASA) to manage the inflammation. Given the diffuse nature of the disease, which 5-ASA formulation would be most appropriate for this patient? a) Canasa b) Rowasa c) Asacol d) Pentasa

D (treats from the jejunum to the rectum = good for diffuse dz)

which drug could a patient with prostate cancer be started on to lower testosterone production? A. Finasteride (Proscar) B. Dutasteride (Avodart) C. Testoderm D. Leuprolide (Lupron)

D. (GnRH analog) finasteride and dutasteride are mainly used to shrink the prostate bc of BPH NOT cancer

A 45-year-old patient with a history of depression presents to the emergency department with confusion, dry mouth, and urinary retention. An electrocardiogram (ECG) reveals a widened QRS complex. Which drug most likely caused this presentation? A. Milnacipran (Savella) B. Mirtazapine (Remeron) C. Fluvoxetine (Luvox) D. Clomipramine (Anafranil)

D. Clomipramine is a TCA → TCAs cause anti-cholinergic effects d/t muscarinic blockade (dry mouth, retention, confusion) and prolonged QRS complex

A patient experiencing antidepressant discontinuation syndrome presents with anxiety, sleep disturbances, and increased symptom recurrence risk. Which SSRI with a longer half-life may have a lower risk of these effects? a) Citalopram (Celexa) b) Paroxetine (Paxil) c) Fluoxetine (Prozac) d) Sertraline (Zoloft)

c

A 45-year-old patient with a history of bipolar disorder is admitted to the emergency department with altered mental status, hyperthermia, autonomic dysregulation, and generalized muscle rigidity. The patient had recently started a new antipsychotic medication for the treatment of manic episodes. Considering the symptoms, which antipsychotic medication is most likely responsible? A) Risperidone (Risperdal) B) Olanzapine (Zyprexa) C) Quetiapine (Seroquel) D) Fluphenazine (Prolixin)

D Haldol and Prolixin both are more likely to cause Neuroleptic malignant syndrome and EPS than other FGAs/SGAs

A 55-year-old female with type 2 diabetes mellitus presents to the clinic complaining of dysuria, urgency, and frequency. She describes a burning sensation during urination and has noticed cloudy urine with an unusual odor. She is currently on multiple medications for diabetes management. Which drug among the following is most likely associated with her urinary symptoms? A) Metformin (Glucophage) B) Linagliptin (Tradjenta) C) Pioglitazone (Actos) D) Empagliflozin (Jardiance)

D SGLT2 inhibitors can cause FUNGAL UTIs bc of renal elimination of glucose (pee it out)

A 55-year-old patient with Type 2 Diabetes Mellitus recently initiated a new antidiabetic medication. The patient reports increased bloating, abdominal pain, and flatulence. Which medication is most likely responsible for these gastrointestinal side effects? A) Metformin (Glucophage) B) Glyburide (Diabeta) C) Pioglitazone (Actos) D) Acarbose (Precose)

D acarbose is metabolized by intestinal bacteria which can cause gas

A T2DM patient presents to the ER with symptoms of hypoglycemia, including diaphoresis, confusion, and palpitations. The patient is managed with metformin but recently started a new medication. Which drug is most likely responsible for the hypoglycemic episode? A) Niacin B) Oral contraceptive C) Hydrochlorothiazide D) Propranolol

D beta blockers can increase hypoglycemic effects of insulin all the other options DECREASE hypoglycemic effects (would need more insulin)