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Pharmacotherapy Review & Drug Interactions Flashcards

7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pharmacotherapy Review & Drug Interactions flashcards as text

  1. A patient on tacrolimus (an immunosuppressant) begins taking St. John's Wort. What outcome is expected?

    Answer: Tacrolimus levels decrease due to CYP3A4 induction, risking organ rejection

    St. John's Wort is a potent CYP3A4 and P-glycoprotein inducer that significantly reduces tacrolimus plasma levels, potentially leading to acute transplant rejection.

  2. Which pharmacodynamic interaction best describes the combination of an ACE inhibitor with a potassium-sparing diuretic?

    Answer: Additive hyperkalemia risk due to reduced aldosterone effect from both agents

    Both ACE inhibitors (which reduce aldosterone) and potassium-sparing diuretics (which block aldosterone action) decrease potassium excretion, creating additive hyperkalemia risk.

  3. A patient on sustained-release theophylline begins ciprofloxacin. What pharmacokinetic change is anticipated?

    Answer: Increased theophylline levels due to CYP1A2 inhibition

    Ciprofloxacin inhibits CYP1A2, the primary enzyme responsible for theophylline metabolism, leading to elevated theophylline levels and potential toxicity (seizures, arrhythmias).

  4. What is the most appropriate intervention when a patient's medication therapy problem involves an adverse drug reaction from a necessary medication?

    Answer: Recommend a dose reduction, symptomatic management, or alternative therapy if available

    In MTM, adverse drug reactions are addressed by assessing severity, considering dose adjustments, adding supportive therapy, or switching to an alternative with a safer profile while maintaining therapeutic goals.

  5. A patient taking lithium is started on hydrochlorothiazide for hypertension. What is the mechanism of the resulting interaction?

    Answer: Thiazides cause sodium depletion, triggering compensatory renal lithium reabsorption and toxicity

    Thiazide-induced sodium depletion causes the kidney to compensatorily reabsorb both sodium and lithium in the proximal tubule, reducing lithium clearance and raising serum levels toward toxicity.

  6. Which parameter is used to calculate the maintenance dose needed to achieve a target steady-state concentration?

    Answer: Clearance × target concentration

    Maintenance dose rate = Clearance × Target steady-state concentration; clearance determines how much drug must be administered per unit time to replace what is eliminated.

  7. A patient taking an SSRI is prescribed tramadol for pain. Which serious adverse effect is of highest concern?

    Answer: Serotonin syndrome due to dual serotonergic activity

    Tramadol inhibits serotonin and norepinephrine reuptake in addition to its opioid activity; combined with an SSRI, this can precipitate serotonin syndrome.