B.Pharm. Bachelor of Pharmacy Clinical Pharmacy & Therapeutics 2 — Questions and Answers
Question 1: What is the recommended first-line antibiotic for uncomplicated urinary tract infections (UTIs) caused by E. coli in the US?
- Ciprofloxacin
- Nitrofurantoin or trimethoprim-sulfamethoxazole (Correct answer)
- Amoxicillin
- Vancomycin
Correct answer: Nitrofurantoin or trimethoprim-sulfamethoxazole
Current US guidelines recommend nitrofurantoin (5 days) or trimethoprim-sulfamethoxazole (3 days) as first-line agents for uncomplicated UTIs due to efficacy and preserving fluoroquinolones.
Question 2: Renal dose adjustment for medications is primarily necessary because the kidneys are responsible for:
- Drug absorption
- Drug metabolism by CYP enzymes
- Elimination of drugs and active metabolites (Correct answer)
- Drug distribution to tissues
Correct answer: Elimination of drugs and active metabolites
The kidneys eliminate many drugs and active metabolites through filtration, secretion, and reabsorption; impaired renal function reduces clearance and can lead to drug accumulation and toxicity.
Question 3: Which medication counseling point is most important for patients taking oral bisphosphonates like alendronate?
- Take with food to avoid GI upset
- Take on empty stomach and remain upright for 30 minutes (Correct answer)
- Take at bedtime for maximum absorption
- Avoid taking with water to increase efficacy
Correct answer: Take on empty stomach and remain upright for 30 minutes
Oral bisphosphonates must be taken on an empty stomach with full water, and patients must remain upright for 30–60 minutes to prevent esophageal irritation and improve absorption.
Question 4: The 'five rights' of medication administration are patient, medication, dose, route, and:
- Frequency
- Time (Correct answer)
- Pharmacist verification
- Diagnosis
Correct answer: Time
The five rights of medication administration are: right patient, right medication, right dose, right route, and right time — a foundational safety framework.
Question 5: Drug-induced nephrotoxicity is a well-known adverse effect of which antibiotic class?
- Penicillins
- Macrolides
- Aminoglycosides (Correct answer)
- Tetracyclines
Correct answer: Aminoglycosides
Aminoglycosides (gentamicin, tobramycin, amikacin) cause nephrotoxicity through accumulation in proximal tubular cells, requiring TDM and renal function monitoring.
Question 6: In patients with chronic kidney disease (CKD), which analgesic should be AVOIDED due to risk of further renal damage?
- Acetaminophen
- NSAIDs (ibuprofen, naproxen) (Correct answer)
- Tramadol
- Low-dose aspirin
Correct answer: NSAIDs (ibuprofen, naproxen)
NSAIDs inhibit prostaglandin-mediated afferent arteriolar dilation in the kidney, reducing glomerular filtration and worsening renal function in CKD patients.
B.Pharm. Bachelor of Pharmacy Clinical Pharmacy & Therapeutics 2
What is the recommended first-line antibiotic for uncomplicated urinary tract infections (UTIs) caused by E. coli in the US?