BCACP Medication Management 2

Question 1

A patient with CKD stage 3b (eGFR 38 mL/min/1.73m²) is prescribed metformin. What is the most appropriate action?

Accepted Answer

Reduce metformin dose and monitor renal function every 3 months

Answer

Continue metformin at full dose

Answer

Discontinue metformin immediately

Answer

Switch to insulin only

Question 2

Which fluoroquinolone interaction most significantly prolongs the QT interval and requires monitoring?

Accepted Answer

Moxifloxacin with amiodarone

Answer

Ciprofloxacin with antacids

Answer

Levofloxacin with warfarin

Answer

Ciprofloxacin with metformin

Question 3

A patient on warfarin begins fluconazole therapy for a vaginal yeast infection. What is the expected pharmacokinetic effect?

Accepted Answer

Increased warfarin levels due to CYP2C9 inhibition

Answer

Decreased warfarin levels due to CYP2C9 induction

Answer

No significant interaction expected

Answer

Decreased warfarin levels due to reduced absorption

Question 4

Which medication requires a REMS program due to risk of serious dermatologic reactions, including Stevens-Johnson syndrome?

Accepted Answer

Carbamazepine in patients of Asian ancestry

Answer

Amoxicillin in penicillin-allergic patients

Answer

Lisinopril in patients with ACE inhibitor cough

Answer

Metoprolol in asthmatic patients

Question 5

A 68-year-old patient is taking simvastatin 40 mg and is started on diltiazem for rate control. What is the most appropriate intervention?

Accepted Answer

Reduce simvastatin dose or switch to a non-CYP3A4-metabolized statin

Answer

Continue both medications without changes

Answer

Double the simvastatin dose to overcome the interaction

Answer

Discontinue diltiazem and use a beta-blocker instead

Question 6

Which parameter is most important to monitor when initiating spironolactone in a patient with heart failure already on an ACE inhibitor?

Accepted Answer

Serum potassium and renal function

Answer

Serum sodium

Answer

Liver enzymes

Answer

Complete blood count

Question 7

A patient with gout and hypertension is on losartan. The physician wants to switch to a different ARB. Which property of losartan is beneficial to retain for this patient?

Accepted Answer

Losartan has uricosuric properties that lower serum uric acid

Answer

Losartan has the longest half-life among ARBs

Answer

Losartan is the only ARB with renal protective effects

Answer

Losartan has the fewest drug interactions among ARBs