Clinical Pharmacology and Therapeutics Flashcards

What is the pharmacological management of diabetic ketoacidosis (DKA) that DHA pharmacists should understand?

Answer: IV insulin infusion, aggressive fluid resuscitation with normal saline, potassium replacement, and bicarbonate in severe acidosis

DKA management requires IV regular insulin infusion, aggressive fluid replacement with 0.9% NaCl, potassium supplementation (monitored closely), and sodium bicarbonate only for pH <6.9.

What anticoagulant therapy options are available in Dubai and what are their key differences?

Answer: Warfarin (requires INR monitoring), DOACs like rivaroxaban/apixaban (fixed dosing, fewer interactions), and heparin (IV/SC for acute management)

Dubai pharmacies dispense warfarin (VKA requiring INR monitoring), DOACs (rivaroxaban, apixaban, dabigatran with fixed dosing and fewer food interactions), and heparins (UFH, LMWH) for acute anticoagulation.

What is the DHA pharmacist's role in antibiotic stewardship?

Answer: Review antibiotic prescriptions for appropriateness, dose optimization, de-escalation, duration, and educate patients on adherence and resistance

DHA pharmacists are integral to antibiotic stewardship: reviewing prescriptions for indication and appropriateness, recommending dose optimization, suggesting de-escalation, monitoring duration, and patient education on adherence.

What is the pharmacokinetic consideration for medication dosing in patients with renal impairment?

Answer: Medications primarily cleared by the kidneys require dose reduction or interval extension based on estimated GFR/creatinine clearance

Renally cleared medications require dose adjustment based on eGFR or CrCl calculations, typically through dose reduction or interval extension, to prevent drug accumulation and toxicity.

What are the key considerations for medication use during Ramadan that DHA pharmacists must address?

Answer: Adjust dosing schedules to Suhoor/Iftar times, modify insulin regimens, counsel on hydration, and identify medications requiring non-fasting routes

DHA pharmacists must help patients adjust medication timing to pre-dawn (Suhoor) and sunset (Iftar) meals, modify diabetes regimens to prevent hypoglycemia, ensure adequate hydration, and identify drugs that break the fast.

What is the pharmacological basis for combination antihypertensive therapy used in Dubai clinical practice?

Answer: Combining drugs from different classes (ACE-I/ARB + CCB + diuretic) addresses multiple pathophysiological mechanisms and improves blood pressure control

Combination therapy targets multiple pathways simultaneously: RAAS blockade (ACE-I/ARB), vascular relaxation (CCB), and volume reduction (diuretic), achieving better BP control with lower individual doses and fewer side effects.