B.Pharm. Bachelor of Pharmacy Clinical Pharmacy & Therapeutics 1 — Questions and Answers
Question 1: Medication reconciliation in clinical pharmacy is defined as:
- Calculating drug dosage adjustments
- The process of comparing a patient's medication orders to all medications the patient has been taking (Correct answer)
- Identifying drug-drug interactions
- Counseling patients on drug side effects
Correct answer: The process of comparing a patient's medication orders to all medications the patient has been taking
Medication reconciliation compares the medications a patient is currently taking against newly prescribed orders to prevent omissions, duplications, and errors during care transitions.
Question 2: A clinical pharmacist performing a comprehensive medication review (CMR) primarily aims to:
- Prescribe new medications
- Identify, prevent, and resolve drug-related problems (Correct answer)
- Perform physical examinations
- Administer intravenous medications
Correct answer: Identify, prevent, and resolve drug-related problems
CMR is a systematic evaluation of a patient's medications to identify and resolve drug-related problems such as adverse effects, interactions, and non-adherence.
Question 3: Which parameter is used to monitor anticoagulant therapy with warfarin?
- Partial thromboplastin time (PTT)
- International Normalized Ratio (INR) (Correct answer)
- Bleeding time
- Platelet count
Correct answer: International Normalized Ratio (INR)
INR standardizes the prothrombin time measurement to monitor warfarin therapy, with a target range of 2.0–3.0 for most indications.
Question 4: Therapeutic drug monitoring (TDM) is most critical for drugs with which characteristic?
- Wide therapeutic index and short half-life
- Narrow therapeutic index and variable pharmacokinetics (Correct answer)
- High protein binding and low clearance
- Low bioavailability and renal excretion
Correct answer: Narrow therapeutic index and variable pharmacokinetics
TDM is essential for drugs with a narrow therapeutic index (e.g., vancomycin, digoxin, lithium) where small changes in plasma levels can cause toxicity or therapeutic failure.
Question 5: Polypharmacy in elderly patients primarily increases the risk of:
- Reduced drug efficacy
- Drug-drug interactions and adverse drug reactions (Correct answer)
- Better therapeutic outcomes
- Improved medication adherence
Correct answer: Drug-drug interactions and adverse drug reactions
Polypharmacy (use of multiple medications) significantly increases the risk of drug-drug interactions, adverse effects, medication errors, and non-adherence, especially in elderly patients.
Question 6: Which adverse drug reaction type is dose-dependent and predictable based on the drug's mechanism of action?
- Type B (idiosyncratic) reactions
- Type A (augmented) reactions (Correct answer)
- Type C (chronic) reactions
- Type D (delayed) reactions
Correct answer: Type A (augmented) reactions
Type A (augmented) adverse drug reactions are dose-dependent, predictable extensions of the drug's pharmacological effect, accounting for approximately 80% of all adverse drug reactions.
B.Pharm. Bachelor of Pharmacy Clinical Pharmacy & Therapeutics 1
Medication reconciliation in clinical pharmacy is defined as: