Medication Management Flashcards
7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medication Management flashcards as text
A patient with type 2 diabetes and a history of heart failure with reduced ejection fraction (HFrEF) is not at goal A1c on metformin alone. Which agent is most preferred to add?
Answer: Empagliflozin
SGLT2 inhibitors like empagliflozin have demonstrated cardiovascular mortality reduction in HFrEF and are preferred by major guidelines for this patient profile.
Which bisphosphonate formulation requires the patient to remain upright for 30 minutes after administration?
Answer: Alendronate oral tablet
Oral alendronate must be taken with a full glass of water on an empty stomach, and the patient must remain upright for at least 30 minutes to prevent esophageal irritation.
A pharmacist is counseling a patient starting isotretinoin. Which program must the patient be enrolled in before dispensing?
Answer: iPLEDGE program
iPLEDGE is the mandatory REMS program for isotretinoin due to its severe teratogenic potential, requiring monthly pregnancy testing for females of reproductive potential.
When converting a patient from oral oxycodone 30 mg every 4 hours to an IV morphine infusion, which step is critical?
Answer: Apply equianalgesic tables and then reduce by 25-50% for cross-tolerance
Equianalgesic conversion followed by a 25-50% dose reduction accounts for incomplete cross-tolerance and individual variation, reducing overdose risk during opioid rotation.
A patient on phenytoin for seizure disorder is started on oral contraceptives. What counseling point is most critical?
Answer: Phenytoin induces CYP enzymes, reducing OCP plasma levels and efficacy
Phenytoin is a potent CYP3A4 inducer that accelerates metabolism of ethinyl estradiol and progestin, potentially leading to contraceptive failure.
Which beta-blocker is considered cardioselective and preferred in a patient with mild asthma requiring treatment for hypertension?
Answer: Metoprolol succinate
Metoprolol succinate is cardioselective (beta-1 selective) at recommended doses, making it preferable over non-selective beta-blockers in patients with reactive airway disease, though caution is still warranted.
A patient reports taking St. John's Wort daily. Which prescribed medication is most at risk for therapeutic failure due to this interaction?
Answer: Cyclosporine
St. John's Wort is a potent inducer of CYP3A4 and P-glycoprotein, dramatically reducing cyclosporine levels and risking acute organ rejection in transplant patients.