APEA Pharmacology Review Questions and Answers Flashcards

A nurse practitioner prescribes methotrexate for rheumatoid arthritis. Which supplement should be co-prescribed to reduce mucosal and hematologic toxicity?

Answer: Folic acid

Methotrexate inhibits folate metabolism; supplementing with folic acid reduces side effects such as oral ulcers, nausea, and cytopenias without reducing efficacy.

Which medication used for type 2 diabetes increases the risk of urinary tract infections and genital mycotic infections due to its mechanism of action?

Answer: SGLT-2 inhibitors

SGLT-2 inhibitors increase urinary glucose excretion, creating a favorable environment for bacterial and fungal growth in the genitourinary tract.

A patient taking amiodarone for atrial fibrillation requires monitoring for which thyroid-related adverse effect?

Answer: Both hypothyroidism and hyperthyroidism

Amiodarone contains high iodine content and can cause both hypo- and hyperthyroidism; thyroid function must be monitored every 6 months.

Which analgesic is most appropriate for mild-to-moderate pain in a patient with chronic kidney disease to avoid nephrotoxicity?

Answer: Acetaminophen

Acetaminophen is the preferred analgesic in CKD patients because it is not nephrotoxic at standard doses, unlike NSAIDs which reduce renal prostaglandin-mediated blood flow.

A patient with a penicillin allergy documented as anaphylaxis requires treatment for a serious infection. What is the cross-reactivity risk with cephalosporins?

Answer: 1-2%

Cross-reactivity between penicillins and cephalosporins is approximately 1-2%, much lower than previously thought, though caution is still warranted with severe allergies.

Which medication used in COPD management is associated with the adverse effect of oral candidiasis and requires rinsing the mouth after use?

Answer: Inhaled corticosteroids

Inhaled corticosteroids can deposit in the oropharynx and suppress local immunity, promoting Candida overgrowth; rinsing the mouth after use reduces this risk.