BCACP Hypertension and Dyslipidemia Therapy 3

Question 1

Which PCSK9 inhibitor is FDA-approved as a twice-yearly subcutaneous injection for LDL reduction?

Accepted Answer

Inclisiran

Answer

Inclisiran is an siRNA that inhibits PCSK9 synthesis and is dosed subcutaneously at baseline, 3 months, then every 6 months.

Question 2

A patient with hypertension and gout flares is on hydrochlorothiazide. What is the most appropriate change?

Accepted Answer

Switch to losartan

Answer

Losartan has a uricosuric effect that makes it the preferred antihypertensive in patients with gout, and switching from a thiazide reduces uric acid elevation.

Question 3

Which lipid-lowering drug is most associated with flushing as a side effect and requires premedication with aspirin?

Accepted Answer

Niacin (nicotinic acid)

Answer

Niacin causes prostaglandin-mediated cutaneous flushing; taking 325 mg aspirin 30 minutes before the dose significantly reduces this effect.

Question 4

A 70-year-old patient is on simvastatin 40 mg and is newly started on amlodipine. What drug interaction concern exists?

Accepted Answer

Amlodipine inhibits CYP3A4 and increases simvastatin exposure

Answer

Amlodipine weakly inhibits CYP3A4 and can modestly increase simvastatin plasma levels, potentially increasing myopathy risk.

Question 5

According to ACC/AHA guidelines, what is the LDL goal for a very high-risk ASCVD patient on maximally tolerated statin therapy?

Accepted Answer

<55 mg/dL

Answer

For very high-risk ASCVD patients (multiple major events or one major event plus multiple high-risk conditions), the 2022 ACC/AHA guidelines suggest an LDL goal of <55 mg/dL.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Hypertension and Dyslipidemia Therapy 3