Patient Counseling & Safety Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Counseling & Safety flashcards as text
A patient taking sildenafil for erectile dysfunction is prescribed isosorbide mononitrate for angina. What is the consultant pharmacist's most critical action?
Answer: Counsel the patient that the combination is absolutely contraindicated due to risk of severe, potentially fatal hypotension
PDE-5 inhibitors combined with nitrates cause profound, unpredictable hypotension and are absolutely contraindicated together.
A patient on levothyroxine reports starting calcium carbonate supplements. What counseling is needed?
Answer: Calcium carbonate significantly reduces levothyroxine absorption and should be taken at least 4 hours apart
Calcium carbonate chelates levothyroxine in the GI tract, reducing its absorption by up to 25%; separating doses by at least 4 hours is required.
A consultant pharmacist reviews a patient's chart and notes that both an ACE inhibitor and an ARB have been prescribed. What is the primary safety concern?
Answer: Increased risk of hyperkalemia, acute kidney injury, and hypotension with dual renin-angiotensin blockade
Dual RAAS blockade with an ACE inhibitor and ARB is associated with increased risk of renal failure, hyperkalemia, and hypotension without meaningful added benefit.
A patient who is breastfeeding asks if it is safe to take codeine for pain relief. What is the most appropriate counseling response?
Answer: Codeine is contraindicated in breastfeeding because ultra-rapid metabolizers can produce dangerous neonatal morphine levels via breast milk
Codeine is converted to morphine by CYP2D6; ultra-rapid metabolizers produce excess morphine that passes into breast milk and can cause neonatal respiratory depression or death.
A newly admitted long-term care resident's medication list includes both a statin and a fibrate. What is the primary safety concern the consultant pharmacist must address?
Answer: Increased risk of myopathy and rhabdomyolysis with combination statin-fibrate therapy
Combining a statin with a fibrate, especially gemfibrozil, substantially increases the risk of muscle toxicity including potentially fatal rhabdomyolysis.
A patient with a penicillin allergy listed as 'anaphylaxis' is prescribed cefazolin for a surgical prophylaxis. What should the consultant pharmacist do?
Answer: Flag the order and consult with the surgical team and allergist; consider alternatives or skin testing given the history of anaphylaxis
While overall cross-reactivity between penicillins and cephalosporins is low, a documented anaphylactic reaction warrants careful risk assessment, prescriber communication, and potential allergist consultation before administration.
A patient taking oral contraceptives (OCP) is prescribed rifampin for tuberculosis. What is the most important counseling point?
Answer: Rifampin is a potent CYP3A4 inducer that significantly reduces OCP efficacy; an additional or alternative non-hormonal contraceptive method is required
Rifampin strongly induces CYP3A4 and other enzymes responsible for OCP metabolism, leading to contraceptive failure; a barrier method is required throughout rifampin therapy and for at least one month after.