Master of Pharmacy: Pharmacology and Therapeutics Flashcards
7 cards from real MPharm Master of Pharmacy practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Master of Pharmacy: Pharmacology and Therapeutics flashcards as text
A patient on warfarin is started on rifampin. What is the expected pharmacokinetic interaction?
Answer: Rifampin induces CYP2C9, decreasing warfarin levels
Rifampin is a potent CYP2C9 inducer that accelerates warfarin metabolism, reducing its anticoagulant effect and requiring dose increases.
Which receptor mechanism explains morphine-induced constipation?
Answer: Activation of mu-opioid receptors in the enteric nervous system
Mu-opioid receptors in the enteric nervous system mediate decreased GI motility and secretion, causing opioid-induced constipation.
A patient with atrial fibrillation and CrCl of 30 mL/min requires anticoagulation. Which DOAC requires the most significant dose adjustment?
Answer: Dabigatran
Dabigatran is ~80% renally eliminated and is contraindicated or requires major dose reduction at CrCl <30 mL/min due to accumulation risk.
The narrow therapeutic index of lithium requires monitoring for toxicity. Which early sign indicates toxicity?
Answer: Coarse tremor, nausea, and diarrhea
Early lithium toxicity (serum level >1.5 mEq/L) presents with coarse tremor, GI disturbances, and drowsiness before progressing to seizures.
Which mechanism accounts for resistance to beta-lactam antibiotics in MRSA?
Answer: Acquisition of mecA gene encoding altered PBP2a
MRSA expresses PBP2a (encoded by mecA), a modified penicillin-binding protein with low affinity for beta-lactams, conferring resistance.
A patient develops serotonin syndrome after adding linezolid to fluoxetine. What is the pharmacodynamic basis?
Answer: Linezolid inhibits MAO, increasing synaptic serotonin alongside SSRI
Linezolid has weak MAO inhibitory activity; combined with fluoxetine's SERT inhibition, it causes excessive serotonergic activity leading to serotonin syndrome.
In heart failure with reduced ejection fraction, why are ACE inhibitors considered first-line?
Answer: They reduce afterload and prevent ventricular remodeling via angiotensin II blockade
ACE inhibitors reduce angiotensin II-mediated vasoconstriction and aldosterone release, decreasing afterload and preventing maladaptive cardiac remodeling.