MPharm Master of Pharmacy Clinical Pharmacy and Patient Care 2 — Questions and Answers
Question 1: Which antidiabetic drug class carries the highest risk of hypoglycemia when used as monotherapy?
- Biguanides
- DPP-4 inhibitors
- Sulfonylureas (Correct answer)
- SGLT-2 inhibitors
Correct answer: Sulfonylureas
Sulfonylureas stimulate insulin secretion independent of glucose levels, making hypoglycemia a primary adverse effect.
Question 2: A clinical pharmacist identifies a patient on lisinopril who develops a persistent dry cough. What is the recommended intervention?
- Add codeine for cough suppression
- Switch to an ARB such as losartan (Correct answer)
- Reduce the lisinopril dose
- Add an antihistamine
Correct answer: Switch to an ARB such as losartan
ACE inhibitor-induced cough is a class effect due to bradykinin accumulation; switching to an ARB eliminates this side effect.
Question 3: Which renal function metric is most important for dose adjustment recommendations in clinical pharmacy?
- Serum albumin
- Estimated GFR (eGFR) (Correct answer)
- Serum sodium
- Hemoglobin A1c
Correct answer: Estimated GFR (eGFR)
eGFR quantifies kidney filtration capacity and is the standard basis for renal dose adjustments of renally cleared drugs.
Question 4: A patient with atrial fibrillation and CrCl of 40 mL/min needs anticoagulation. Which DOAC requires the most significant dose reduction?
- Apixaban
- Rivaroxaban
- Dabigatran (Correct answer)
- Edoxaban
Correct answer: Dabigatran
Dabigatran is approximately 80% renally eliminated and requires significant dose reduction or avoidance at CrCl < 50 mL/min.
Question 5: What is the purpose of a pharmacist-conducted medication reconciliation at hospital admission?
- Verify insurance coverage for all prescribed drugs
- Create a complete and accurate list of current medications to prevent discrepancies (Correct answer)
- Substitute all brand drugs with generics
- Identify off-label drug use for regulatory reporting
Correct answer: Create a complete and accurate list of current medications to prevent discrepancies
Medication reconciliation compares the patient's home medication list to admission orders to prevent omissions, duplications, and errors.
Question 6: Which tool is used by clinical pharmacists to assess the appropriateness of medications in elderly patients?
- APACHE II Score
- Beers Criteria (Correct answer)
- CURB-65 Score
- SOFA Score
Correct answer: Beers Criteria
The AGS Beers Criteria lists medications that are potentially inappropriate for use in older adults due to increased risks of adverse effects.
MPharm Master of Pharmacy Clinical Pharmacy and Patient Care 2
Which antidiabetic drug class carries the highest risk of hypoglycemia when used as monotherapy?