AP Pharmacology & Medication Management 2

Question 1

A patient taking warfarin asks about using danshen (Salvia miltiorrhiza). What is the primary concern?

Accepted Answer

Danshen potentiates warfarin's anticoagulant effect, increasing bleeding risk

Answer

Danshen inhibits warfarin metabolism and has its own anticoagulant properties, significantly increasing bleeding risk.

Question 2

Which herb is most associated with causing hypertensive crisis when combined with MAO inhibitors?

Accepted Answer

Ephedra (Ma Huang)

Answer

Ephedra contains ephedrine, which combined with MAO inhibitors can cause dangerous hypertensive crisis due to increased sympathomimetic activity.

Question 3

A patient on metformin reports using bitter melon (Momordica charantia) daily. The acupuncture physician should monitor for:

Accepted Answer

Hypoglycemia

Answer

Bitter melon has hypoglycemic properties that can potentiate metformin's blood glucose-lowering effect, risking hypoglycemia.

Question 4

Which of the following best describes the mechanism by which St. John's Wort reduces effectiveness of many medications?

Accepted Answer

It induces CYP3A4 and P-glycoprotein, increasing drug metabolism and efflux

Answer

St. John's Wort is a potent inducer of CYP3A4 and P-glycoprotein, leading to reduced plasma levels of many drugs including cyclosporine, antiretrovirals, and oral contraceptives.

Question 5

A patient using fish oil supplements at high doses (>3g EPA/DHA daily) is scheduled for surgery. The AP should:

Accepted Answer

Advise discontinuation 1-2 weeks prior to surgery due to antiplatelet effects

Answer

High-dose fish oil has significant antiplatelet effects and should be discontinued 1-2 weeks before surgery to reduce bleeding risk.

AP Practice Test

AP Practice Test

AP Pharmacology & Medication Management 2