Family Practice Exam Family Practice Exam Pharmacology and Prescribing 2

Question 1

A patient on statin therapy develops significant myalgia and a markedly elevated CK. What is the correct next step?

Accepted Answer

Discontinue the statin immediately

Answer

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?

Accepted Answer

ACE inhibitors

Answer

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?

Accepted Answer

Tendon rupture

Answer

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?

Accepted Answer

Naloxone

Answer

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?

Accepted Answer

Discontinue metformin

Answer

Metformin is contraindicated when GFR falls below 30 mL/min due to impaired renal clearance and the risk of fatal lactic acidosis.

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