DO Osteopathic Pharmacology 1

Question 1

Which drug class is the first-line treatment for hypertension in a patient with type 2 diabetes and proteinuria?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors reduce intraglomerular pressure and have renoprotective effects in diabetic nephropathy by blocking the renin-angiotensin-aldosterone system.

Question 2

A patient stabilized on warfarin is started on rifampin for latent TB. What is the expected effect on INR?

Accepted Answer

INR decreases significantly

Answer

Rifampin is a potent CYP450 inducer that accelerates warfarin metabolism, significantly reducing INR and increasing clot risk.

Question 3

Which opioid analgesic is contraindicated in renal failure due to accumulation of a toxic active metabolite?

Accepted Answer

Morphine

Answer

Morphine-6-glucuronide, a potent active metabolite, accumulates in renal failure and causes prolonged sedation and respiratory depression.

Question 4

A patient receiving IV vancomycin develops flushing and erythema over the face, neck, and chest. What is the mechanism?

Accepted Answer

Direct mast cell degranulation causing histamine release

Answer

Red man syndrome results from non-immune direct mast cell degranulation and histamine release, which is rate-dependent and not a true allergy.

Question 5

Which beta-blocker is most cardioselective and preferred when a beta-blocker is necessary in a patient with mild COPD?

Accepted Answer

Metoprolol

Answer

Metoprolol selectively blocks beta-1 receptors with minimal beta-2 activity, reducing the risk of bronchospasm compared to non-selective agents.

DO - Doctor of Osteopathic Medicine Practice Test

DO - Doctor of Osteopathic Medicine Practice Test

DO Osteopathic Pharmacology 1