Family Practice Exam Family Practice Exam Pharmacology and Prescribing 2 — Questions and Answers
Question 1: A patient on statin therapy develops significant myalgia and a markedly elevated CK. What is the correct next step?
- Continue the statin and monitor
- Reduce the statin dose
- Discontinue the statin immediately (Correct answer)
- Add CoQ10 supplementation
Correct answer: Discontinue the statin immediately
Statin-induced myopathy with significantly elevated CK requires immediate drug discontinuation to prevent progression to rhabdomyolysis.
Question 2: Which antihypertensive drug class is absolutely contraindicated in the second and third trimesters of pregnancy?
- Beta-blockers
- ACE inhibitors (Correct answer)
- Calcium channel blockers
- Methyldopa
Correct answer: ACE inhibitors
ACE inhibitors cause fetal renal dysgenesis, oligohydramnios, and neonatal renal failure when used in the second or third trimester.
Question 3: A patient on ciprofloxacin develops Achilles tendon pain. What is the most serious complication to warn about?
- Septic arthritis
- Tendon rupture (Correct answer)
- Reactive arthritis
- Bursitis
Correct answer: Tendon rupture
Fluoroquinolones carry an FDA black-box warning for tendinitis and tendon rupture, most commonly affecting the Achilles tendon.
Question 4: Which agent is used to immediately reverse opioid-induced respiratory depression in the emergency setting?
- Flumazenil
- Naloxone (Correct answer)
- Physostigmine
- Atropine
Correct answer: Naloxone
Naloxone is a competitive opioid receptor antagonist that rapidly reverses respiratory depression, sedation, and miosis from opioid overdose.
Question 5: A type 2 diabetic patient on metformin is found to have a GFR of 28 mL/min. What is the appropriate management?
- Continue at current dose
- Increase the dose
- Discontinue metformin (Correct answer)
- Switch to maximum-dose metformin
Correct answer: Discontinue metformin
Metformin is contraindicated when GFR falls below 30 mL/min due to impaired renal clearance and the risk of fatal lactic acidosis.
Question 6: Which OTC analgesic is safest for pain management in a patient with stage 3 chronic kidney disease?
- Ibuprofen
- Naproxen
- Acetaminophen (Correct answer)
- Aspirin
Correct answer: Acetaminophen
Acetaminophen is preferred over NSAIDs in CKD because it does not inhibit renal prostaglandins or further reduce glomerular filtration rate.
Family Practice Exam Family Practice Exam Pharmacology and Prescribing 2
A patient on statin therapy develops significant myalgia and a markedly elevated CK.
What is the correct next step?