BCACP Medication Management 5

Question 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?

Accepted Answer

Decreases raltegravir levels by inducing UGT1A1, requiring dose doubling

Answer

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

Question 2

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

Accepted Answer

Sulfonylureas

Answer

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

Question 3

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

Accepted Answer

Immediately discontinue clozapine and monitor ANC daily

Answer

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

Question 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?

Accepted Answer

Raloxifene is contraindicated in patients with active or past VTE

Answer

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

Question 5

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

Accepted Answer

Adding tramadol for pain management

Answer

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

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Medication Management 5