CCP Drug Therapy Management 3

Question 1

A patient on chronic opioid therapy for pain management develops opioid-induced constipation unresponsive to stimulant laxatives. Which agent is specifically indicated for this condition?

Accepted Answer

Methylnaltrexone

Answer

Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist specifically approved for opioid-induced constipation that does not respond to laxatives.

Question 2

When reviewing a patient's medication regimen, a consultant pharmacist identifies that an ACE inhibitor and an angiotensin receptor blocker are prescribed together. This combination is generally considered:

Accepted Answer

Potentially harmful and should be avoided due to increased risk of hyperkalemia and renal failure

Answer

Dual renin-angiotensin-aldosterone system blockade with ACE inhibitors and ARBs together is not recommended as it increases risk of hyperkalemia, hypotension, and acute kidney injury.

Question 3

A resident with Parkinson's disease is admitted with worsening motor symptoms. The nursing staff administered metoclopramide for nausea. What is the primary concern?

Accepted Answer

Metoclopramide is a dopamine antagonist that can worsen Parkinson's symptoms

Answer

Metoclopramide blocks dopamine receptors centrally, directly antagonizing the dopaminergic therapy used in Parkinson's disease and worsening motor symptoms.

Question 4

Which Beers Criteria medication should be avoided in older adults due to its high anticholinergic burden and risk of cognitive impairment?

Accepted Answer

Diphenhydramine

Answer

Diphenhydramine has significant anticholinergic effects and is listed in the Beers Criteria as potentially inappropriate in older adults due to increased risk of delirium and cognitive decline.

Question 5

A patient with chronic kidney disease (eGFR 25 mL/min) is prescribed metformin for type 2 diabetes. What is the most appropriate recommendation?

Accepted Answer

Discontinue metformin due to risk of lactic acidosis at this level of renal impairment

Answer

Metformin is contraindicated when eGFR falls below 30 mL/min due to accumulation and increased risk of lactic acidosis.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Drug Therapy Management 3