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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.

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  1. A patient with HIV is started on rifampin for TB co-infection and is also taking raltegravir. What effect does rifampin have on raltegravir?

    Answer: Decreases raltegravir levels by inducing UGT1A1, requiring dose doubling

    Rifampin induces UGT1A1, the primary metabolic pathway for raltegravir, requiring the raltegravir dose to be doubled to 800 mg twice daily during co-administration.

  2. Which antidiabetic medication class is associated with the highest risk of hypoglycemia when used as monotherapy?

    Answer: Sulfonylureas

    Sulfonylureas stimulate insulin secretion independent of glucose levels, resulting in the highest hypoglycemia risk among oral antidiabetic classes when used as monotherapy.

  3. A patient prescribed clozapine develops an absolute neutrophil count (ANC) of 450 cells/µL. What is the most appropriate action?

    Answer: Immediately discontinue clozapine and monitor ANC daily

    An ANC below 500 cells/µL indicates severe neutropenia requiring immediate clozapine discontinuation per the Clozapine REMS program requirements.

  4. A 55-year-old woman with postmenopausal osteoporosis and a history of deep vein thrombosis asks about raloxifene. What is the most important contraindication to address?

    Answer: Raloxifene is contraindicated in patients with active or past VTE

    Raloxifene, a SERM, increases the risk of VTE and is contraindicated in patients with a history of venous thromboembolism.

  5. Which drug interaction most significantly increases the risk of serotonin syndrome in a patient on sertraline?

    Answer: Adding tramadol for pain management

    Tramadol inhibits serotonin reuptake and, combined with an SSRI like sertraline, creates a significant risk of serotonin syndrome.

  6. A patient with COPD is prescribed tiotropium via HandiHaler. Which counseling point is most critical for proper use?

    Answer: Inhale slowly and deeply, hold breath for 10 seconds, and do not swallow the capsule

    Tiotropium HandiHaler requires slow deep inhalation to ensure dry powder deposition in the airways; capsules are perforated in the device and must never be swallowed.

  7. A patient on chronic prednisone therapy is being evaluated for bone health. Which combination of preventive therapies is most appropriate per guidelines?

    Answer: Calcium 1000-1200 mg daily, vitamin D 600-800 IU daily, and bisphosphonate therapy if fracture risk is high

    Guidelines recommend calcium and vitamin D supplementation for all patients on chronic glucocorticoids, with bisphosphonate therapy added based on FRAX-calculated fracture risk.