BCACP Hypertension and Dyslipidemia Therapy 5

Question 1

A patient on atorvastatin 40 mg has LDL of 85 mg/dL but is very high-risk ASCVD. After maximizing statin dose, which add-on therapy should be considered first per ACC/AHA guidelines?

Accepted Answer

Ezetimibe

Answer

ACC/AHA guidelines recommend adding ezetimibe as the first non-statin therapy in very high-risk patients whose LDL remains above goal on maximally tolerated statin therapy.

Question 2

Which antihypertensive drug class is the recommended first-line therapy for a patient with hypertension and proteinuric diabetic nephropathy?

Accepted Answer

ACE inhibitors or ARBs

Answer

ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria in diabetic nephropathy, providing renoprotection beyond blood pressure lowering.

Question 3

A patient taking simvastatin 80 mg is newly prescribed clarithromycin for a respiratory infection. What is the most appropriate pharmacist intervention?

Accepted Answer

Hold simvastatin during the 5-day antibiotic course

Answer

Clarithromycin is a potent CYP3A4 inhibitor that dramatically increases simvastatin exposure; holding the statin for the short antibiotic course is the recommended strategy.

Question 4

Hypertriglyceridemia (TG >500 mg/dL) poses what primary acute risk that warrants immediate treatment?

Accepted Answer

Acute pancreatitis

Answer

Severely elevated triglycerides (>500 mg/dL) increase the risk of acute pancreatitis, which is the primary reason for urgent pharmacologic intervention at this level.

Question 5

Which antihypertensive drug is preferred in a patient with hypertension and a concurrent migraine prophylaxis indication?

Accepted Answer

Propranolol

Answer

Propranolol is FDA-approved for migraine prophylaxis and also lowers blood pressure, making it an ideal single-agent choice for patients with both conditions.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Hypertension and Dyslipidemia Therapy 5