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CPJE Drug Interactions and Therapeutics Flashcards

6 cards from real CPJE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 CPJE Drug Interactions and Therapeutics flashcards as text

  1. Which drug requires dose adjustment when creatinine clearance falls below 30 mL/min?

    Answer: Gabapentin

    Gabapentin is renally eliminated unchanged; dose reduction or extended dosing intervals are required in moderate-to-severe renal impairment.

  2. A patient taking sildenafil for pulmonary hypertension is prescribed isosorbide mononitrate. What is the risk?

    Answer: Severe hypotension

    PDE5 inhibitors and nitrates both cause vasodilation; their combination can produce life-threatening hypotension.

  3. Which anticoagulant interaction with aspirin increases hemorrhagic risk most significantly?

    Answer: All equally increase hemorrhagic risk

    Aspirin's antiplatelet effect combined with any anticoagulant—warfarin, heparin, or direct oral anticoagulants—significantly increases the risk of major bleeding.

  4. Concurrent use of carbamazepine and oral contraceptives is problematic because carbamazepine:

    Answer: Induces CYP enzymes, reducing contraceptive plasma levels

    Carbamazepine is a strong CYP3A4 inducer that accelerates metabolism of estrogen and progestin, potentially causing contraceptive failure.

  5. A patient on clopidogrel is prescribed omeprazole. What interaction concern exists?

    Answer: Omeprazole inhibits CYP2C19, reducing clopidogrel activation

    Clopidogrel is a prodrug activated by CYP2C19; omeprazole's inhibition of this enzyme reduces active metabolite formation and antiplatelet efficacy.

  6. Which combination is most likely to cause additive nephrotoxicity in a hospitalized patient?

    Answer: Vancomycin and gentamicin

    Both vancomycin and aminoglycosides like gentamicin are nephrotoxic, and their combination substantially increases the risk of acute kidney injury.