Therapeutic Plan Assessment Flashcards

A patient with newly diagnosed HIV is to start an integrase inhibitor regimen. Which baseline test guides whether abacavir can be safely used?

Answer: HLA-B*5701 testing

Abacavir hypersensitivity is strongly associated with HLA-B*5701, so screening is required before use.

A patient on chronic NSAIDs for arthritis with a history of peptic ulcer should receive which protective therapy?

Answer: A proton pump inhibitor

PPIs reduce NSAID-related GI ulcer risk in high-risk patients.

Which adjustment is appropriate for a patient on vancomycin with a trough of 25 mcg/mL and rising creatinine?

Answer: Hold the dose and reassess renal function

A supratherapeutic vancomycin trough with rising creatinine suggests accumulation and nephrotoxicity, warranting holding and reassessment.

A patient taking levothyroxine also begins calcium carbonate supplements. What counseling is needed?

Answer: Separate administration by at least 4 hours

Calcium binds levothyroxine and reduces absorption, so dosing should be separated by several hours.

A patient with COPD on a long-acting beta agonist remains symptomatic. Which add-on is most appropriate?

Answer: A long-acting muscarinic antagonist

Adding a LAMA to a LABA improves symptom control in COPD per guideline-based escalation.

A patient on digoxin presents with nausea, visual halos, and a level of 2.8 ng/mL. What is the best action?

Answer: Hold digoxin and check potassium

Digoxin toxicity (level >2 ng/mL with symptoms) requires holding the drug and assessing potassium.

Which therapy is most appropriate first-line for a patient with a new VTE and normal renal function who prefers oral therapy without monitoring?

Answer: A direct oral anticoagulant such as rivaroxaban

DOACs are preferred first-line for VTE in patients without contraindications and require no routine monitoring.